Provider Demographics
NPI:1730876186
Name:HALL, JESSICA MARIA (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIA
Last Name:HALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 BYPASS RD
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1602
Mailing Address - Country:US
Mailing Address - Phone:606-430-4673
Mailing Address - Fax:606-218-4696
Practice Address - Street 1:911 BYPASS RD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1602
Practice Address - Country:US
Practice Address - Phone:606-424-7113
Practice Address - Fax:606-284-2039
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY4001260363LF0000X
KY3013821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily