Provider Demographics
NPI:1871464891
Name:HALL, KATY ELIZABETH (CSFA)
Entity type:Individual
Prefix:MS
First Name:KATY
Middle Name:ELIZABETH
Last Name:HALL
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8737 COMO LAKE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8431
Mailing Address - Country:US
Mailing Address - Phone:904-862-0633
Mailing Address - Fax:
Practice Address - Street 1:8737 COMO LAKE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-8431
Practice Address - Country:US
Practice Address - Phone:904-862-0633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty