Constance Hall, EDD/CI, MSN, BA, RN
Individual provider Active NPI Driver · Pine Bluff, AR
NPI 1235762121 · NPPES record last updated Feb 19, 2020
Key facts
- NPI
- 1235762121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- CATCH58 (AR)
- Practice address
- 3605 S Holly St
Pine Bluff, AR 71603-6253 - Phone
- (870) 441-2064
- NPI assigned
- Feb 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts, Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CATCH58 | AR | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | CATCH58 | AR | Yes |
Addresses
Primary practice location
3605 S Holly St
Pine Bluff, AR 71603-6253
Mailing address
3605 S Holly St
Pine Bluff, AR 71603-6253
Phone (870) 441-2064
Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.