Provider Demographics
NPI:1144055237
Name:THUENEN, HALLIE RUANE (CRNP PNP-PC)
Entity type:Individual
Prefix:MRS
First Name:HALLIE
Middle Name:RUANE
Last Name:THUENEN
Suffix:
Gender:F
Credentials:CRNP PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5729 COVE COMMONS DR SE STE C
Mailing Address - Street 2:
Mailing Address - City:BROWNSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35741-3501
Mailing Address - Country:US
Mailing Address - Phone:256-367-2686
Mailing Address - Fax:256-292-0114
Practice Address - Street 1:5729 COVE COMMONS DR SE STE C
Practice Address - Street 2:
Practice Address - City:BROWNSBORO
Practice Address - State:AL
Practice Address - Zip Code:35741-3501
Practice Address - Country:US
Practice Address - Phone:256-367-2686
Practice Address - Fax:256-292-0114
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-179601363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics