Provider Demographics
NPI:1659648640
Name:HALL, GAIL LOUISE
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:LOUISE
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 1:282 LANGFORD CREEK RD
Mailing Address - Street 2:
Mailing Address - City:VAN ETTEN
Mailing Address - State:NY
Mailing Address - Zip Code:14889-9414
Mailing Address - Country:US
Mailing Address - Phone:607-589-4211
Mailing Address - Fax:607-589-3003
Practice Address - Street 1:3 CENTER ST
Practice Address - Street 2:SPENCER VAN ETTEN MIDDLE SCHOOL
Practice Address - City:SPENCER
Practice Address - State:NY
Practice Address - Zip Code:14883
Practice Address - Country:US
Practice Address - Phone:607-589-7128
Practice Address - Fax:607-589-3003
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287054-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool