Provider Demographics
NPI:1659256303
Name:HALL, JAMAL ROSHOD
Entity type:Individual
Prefix:
First Name:JAMAL
Middle Name:ROSHOD
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 SIERRA HIGHLANDS DR APT C117
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-2335
Mailing Address - Country:US
Mailing Address - Phone:775-683-0130
Mailing Address - Fax:
Practice Address - Street 1:2175 SIERRA HIGHLANDS DR APT C117
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-2335
Practice Address - Country:US
Practice Address - Phone:775-683-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health