Provider Demographics
NPI:1043703234
Name:MCNEELEY, JANNETT KAY (HIS)
Entity Type:Individual
Prefix:
First Name:JANNETT
Middle Name:KAY
Last Name:MCNEELEY
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327B S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-2180
Mailing Address - Country:US
Mailing Address - Phone:270-365-0003
Mailing Address - Fax:270-365-0003
Practice Address - Street 1:327B S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-2180
Practice Address - Country:US
Practice Address - Phone:270-365-0003
Practice Address - Fax:270-365-0003
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY148282237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist