Provider Demographics
NPI:1013199066
Name:KNEELAND, NANCY
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:KNEELAND
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:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:46165-0091
Mailing Address - Country:US
Mailing Address - Phone:317-442-3840
Mailing Address - Fax:
Practice Address - Street 1:1481 WEST 10TH ST.
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-988-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-02
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001648A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist