Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 5014624 | NC |
NPI | 1023631421 |
---|---|
Provider Name | Dr. Holley Roberson Hall |
First Address | Greensboro, NC 27411-0001 |
Second Address | Greensboro, NC 27411-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2020 |
Last Update Date | 01/07/2021 |