Provider Demographics
NPI:1861269540
Name:HALL, JAMIE J
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:J
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 LAKEPOINTE DR APT 102
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43619-2155
Mailing Address - Country:US
Mailing Address - Phone:419-252-0375
Mailing Address - Fax:
Practice Address - Street 1:3615 LAKEPOINTE DR APT 102
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43619-2155
Practice Address - Country:US
Practice Address - Phone:419-252-0375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide