1295734002 NPI number — MS. DEBORAH YOUNG HALL RNC,WHCNP

Table of content: MS. DEBORAH YOUNG HALL RNC,WHCNP (NPI 1295734002)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295734002 NPI number — MS. DEBORAH YOUNG HALL RNC,WHCNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALL
Provider First Name:
DEBORAH
Provider Middle Name:
YOUNG
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RNC,WHCNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295734002
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1305 WONDER WORLD DR
Provider Second Line Business Mailing Address:
SUITE 209
Provider Business Mailing Address City Name:
SAN MARCOS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78666-7546
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-396-7575
Provider Business Mailing Address Fax Number:
512-396-7555

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1305 WONDER WORLD DR
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
SAN MARCOS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78666-7546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-396-7575
Provider Business Practice Location Address Fax Number:
512-396-7555
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  674498 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 674498 . This is a "BOARD OF NURSE EXAMINERS-" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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