MRS. MARY LYDIA HALL (NPI# 1902366495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902366495 |
| Entity Type | Individual |
| Full Name | MRS. MARY LYDIA HALL |
| Credential | AGPCNP |
| Practice Address |
501 Avalon Way Ste C Brandon MS 39047-7500 |
| Mailing Address |
911 Cedar Hill Dr Clinton MS 39056-3701 |
| Practice Telephone | 6015737012 |
| Mailing Telephone | 6015946335 |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2019-06-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
903270 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528673589 | Mary A Hall | Registered Nurse | 622 Mary St, Warminster, PA 18974-2800 | 2020-09-15 |
| 1063042927 | Mary Gillon Hall | Nurse Practitioner | 90 La Rue Pl Nw, Atlanta, GA 30327-4075 | 2020-01-20 |
| 1396396776 | Mary Melyssa Hall | Music Therapist | 99 Fort Washington Ave Lowr Level, New York, NY 10032-4655 | 2019-09-26 |
| 1619524303 | Mary L Hall | Occupational Therapist | 2980 Hermitage Dr, Sumter, SC 29150-6006 | 2019-08-19 |
| 1801353693 | Mary B Hall | Dietitian, Registered | 507 Brooks Ave, San Jose, CA 95125-1620 | 2019-02-27 |
| 1346735529 | Mary Justine Hall | Acupuncturist | 54 W Twin Oaks Ter Ste 13, South Burlington, VT 05403-7141 | 2018-06-29 |
| 1144721663 | Mary Hall | Technician | 1730 7th St Nw Apt 502, Washington, DC 20001-3132 | 2018-02-21 |
| 1538675244 | Mary Elizabeth Hall | Social Worker | 411 Stave Mill Rd, Murphysboro, IL 62966-4888 | 2017-12-18 |
| 1043682479 | Mary Hall | Developmental Therapist | 4720 Fox Den Ct, Louisville, KY 40241-1008 | 2015-10-25 |
| 1669870374 | Mary Lois Hall | Pediatrics | 3500 Humboldt Ave S, Minneapolis, MN 55408-3316 | 2014-12-11 |
| Street Address |
501 AVALON WAY STE C |
| City | BRANDON |
| State | MS |
| Zip Code | 39047-7500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093280679 | Brittany Chantriece Burage | Nurse Practitioner | 501 Avalon Way Ste C, Brandon, MS 39047-7500 | 2018-10-10 |
| 1689289464 | Heather Phillips Silverii | Nurse Practitioner | 501 Avalon Way Ste C, Brandon, MS 39047-7500 | 2020-09-09 |
| 1114571957 | Jasmine Arlean Blanks | Nurse Practitioner | 501 Avalon Way Ste C, Brandon, MS 39047-7500 | 2019-07-30 |
| 1508429978 | Roy A West | Nurse Practitioner | 501 Avalon Way Ste C, Brandon, MS 39047-7500 | 2019-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368783 | Siyuan Chen Kennedy | Counselor | 108 Sandstone Drive, Brandon, MS 39047 | 2020-05-20 |
| 1568019784 | Juarez Brown Emerson | Registered Nurse | 426 Pinebrook Circle, Brandon, MS 39047 | 2019-08-22 |
| 1649764127 | Specialty Diagnostics LLC | Family Medicine | 1149 Old Fannin Rd Ste 22, Brandon, MS 39047 | 2018-06-19 |
| 1528423035 | Kathlene Strangeman | Social Worker | 111 Lakeshore Dr Apt G403, Brandon, MS 39047 | 2015-12-28 |
| 1174935076 | Anthony Davis | Counselor | 198 Bellegrove Cir, Brandon, MS 39047 | 2014-05-27 |
| 1144659178 | Medical Foundation of Central Ms, Inc | Family Medicine | 1887 Spillway Rd., Brandon, MS 39047 | 2013-11-12 |
| 1437429941 | Picton Timothy Evans | Pharmacist | 150 B Cumberland Ed, Brandon, MS 39047 | 2012-01-01 |
| 1275828030 | Kathryn Audell Piburn | Nurse Practitioner | 1887 Spillway Rd Ste 140, Brandon, MS 39047 | 2011-06-09 |
| 1801930532 | Susanne Reynolds Moore | Dentist | 1149 Old Fannin Rd, Suite 26, Brandon, MS 39047 | 2007-02-16 |
| 1194898429 | Brookshire Grocery Company | Durable Medical Equipment & Medical Supplies | 143 Plaza Drive Ext, Attention Pharmacy Dept, Brandon, MS 39047 | 2006-11-16 |
| Find all providers in zip 39047 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548782592 | Tm Medical Associates, LLC | Nurse Practitioner | 131 N Moon Ave Ste 3&4, Brandon, FL 33510-4418 | 2017-07-12 |
| 1780125302 | Debra Brown Willis | Nurse Practitioner | 216 Belle Oak Dr, Brandon, MS 39042-8251 | 2017-03-15 |
| 1760886972 | Casey Lee Molumby | Nurse Practitioner | 613 Medical Care Drive, Brandon, FL 33511 | 2014-10-17 |
| 1447666870 | Robert Frank | Nurse Practitioner | 547 E Washington St, Brandon, WI 53919-8558 | 2014-07-07 |
| 1710140488 | Mary Grace Lemmenes | Nurse Practitioner | N4439 Meadow Rd, Brandon, WI 53919-9734 | 2008-07-03 |
| 1912513474 | Andrea Jessica Lynn | Nurse Practitioner | 425 S Kings Ave, Brandon, FL 33511-5919 | 2020-09-21 |
| 1528524980 | Yendrys Calderin | Nurse Practitioner | 110 Lithia Pinecrest Rd Ste H, Brandon, FL 33511-5300 | 2019-02-11 |
| 1033613070 | Sabrina Sportman | Nurse Practitioner | 635 Eichenfeld Dr, Brandon, FL 33511-5908 | 2018-03-23 |
| 1205349594 | Todd Joseph Smith | Nurse Practitioner | 61 Court Dr, Brandon, VT 05733-8407 | 2017-11-09 |
| 1235673310 | Elena Nelson | Nurse Practitioner | 605 Medical Care Dr, Brandon, FL 33511-5942 | 2016-12-08 |
| Find all providers in BRANDON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.