Provider Demographics
NPI:1598656324
Name:HALL, ELISE A (CBD)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:A
Last Name:HALL
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 NORTHDALE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1646
Mailing Address - Country:US
Mailing Address - Phone:530-957-2899
Mailing Address - Fax:
Practice Address - Street 1:5374 HIGHWAY 45 N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2947
Practice Address - Country:US
Practice Address - Phone:530-957-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula