Provider Demographics
NPI:1053154690
Name:EBORALL, HALLE
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:
Last Name:EBORALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 E RIO SALADO PKWY STE 900
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-9126
Mailing Address - Country:US
Mailing Address - Phone:480-864-3733
Mailing Address - Fax:
Practice Address - Street 1:60 E RIO SALADO PKWY STE 900
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-9126
Practice Address - Country:US
Practice Address - Phone:480-864-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician