Individual provider · Type 1 NPI

Nicole Leigh Ann Hallberg, PA-C

Physician Assistant · Daytona Beach, FL

NPI number 1366814626 Active

Practice location

305 Memorial Medical Pkwy Ste 505
Daytona Beach, FL 32117-5170

Call (386) 231-3540 Map

Fax (386) 231-3544

Mailing address

PO Box 935921
Atlanta, GA 31193-5921

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA9110047 (FL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1366814626

Nicole Leigh Ann Hallberg, PA-C's National Provider Identifier is 1366814626, issued on Oct 27, 2015. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Daytona Beach, FL. The record was last updated on Apr 28, 2026.