Provider Demographics
NPI:1578929410
Name:HALL, RICHARD II (CRNP)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HALL
Suffix:II
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 DIAMOND DR
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4390
Mailing Address - Country:US
Mailing Address - Phone:814-659-8011
Mailing Address - Fax:
Practice Address - Street 1:138 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8460
Practice Address - Country:US
Practice Address - Phone:814-696-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023461363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily