Most Relevant Information
Provider Data
| NPI Number: | 1003379207 |
| Provider Name: | MALISSA HALLAHAN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WM0102X |
| Specialty: | Registered Nurse |
| License Number: | 1-141039 |
Most Important Dates
| Enumeration Date: | 04/13/2019 |
| Last Updated: | 03/03/2020 |
Provider Practice Location
1500 FLORIDA AVE
MODESTO
CA
953504408
Practice Location Phone/Fax
| Phone: | 8666824842 |
| Fax: | 8774356573 |
Provider Mailing Location
737 W CHILDS AVE
MERCED
CA
953416805
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |