Hall, Shannon D Dale
Hall, Shannon D Dale is an individual health care provider with primary practice located at 500 College St Yale New Haven Hospital, New Haven CT 06511-8962. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Hall, Shannon D Dale can be contacted via phone (203) 432-2700.Contact Information
Primary practice address
500 College St Yale New Haven Hospital
New Haven CT 06511-8962
Phone: (203) 432-2700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 071173 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 003790 | Connecticut |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 20635 | South Carolina |
Profile Details
| NPI number | 1821098930 |
|---|---|
| LBN Legal business name | Hall, Shannon D Dale |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Dec 21st, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821098930 | NPPES |
| South Carolina | MEDICAID | PENDING | |
| South Carolina | MEDICAID | 74007634 | |
| South Carolina | MEDICAID | 3634996 | |
| South Carolina | Other | 4072296 |
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