| Doctor Name: | TAMARA JEAN HALL |
| NPI Number: | 1669446126 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | 091000337RN |
| Business Practice Address: | 377 Th Medical Group Mdos/sgomp Kirtland Afb, NM - 871170001 |
| Business Phone Number: | 5058463701 |
| Business Fax Number: | |
| Mailing Address: | 1529 Blue Spruce Dr Ne, RIO RANCHO |
| State: | NM |
| Postal Code: | 871440594 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2006 |
| NPI Last Update Date: | 06/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 091000337RN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |