Provider Demographics
NPI:1033708185
Name:NEELY, HALI HODGIN (NP)
Entity Type:Individual
Prefix:
First Name:HALI
Middle Name:HODGIN
Last Name:NEELY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HALI
Other - Middle Name:HODGIN
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:525 VERDAE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4021
Mailing Address - Country:US
Mailing Address - Phone:864-720-1900
Mailing Address - Fax:
Practice Address - Street 1:525 VERDAE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4021
Practice Address - Country:US
Practice Address - Phone:864-720-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24657363LF0000X
SC232188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily