Provider Demographics
NPI:1861218406
Name:HALL, SHEENA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 COUNTY ROAD 797
Mailing Address - Street 2:
Mailing Address - City:VALLEY HEAD
Mailing Address - State:AL
Mailing Address - Zip Code:35989-5028
Mailing Address - Country:US
Mailing Address - Phone:256-997-3256
Mailing Address - Fax:
Practice Address - Street 1:1848 ROSSVILLE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1932
Practice Address - Country:US
Practice Address - Phone:423-551-6555
Practice Address - Fax:256-304-5456
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-179965363LA2100X
TN37783363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care