Provider Demographics
NPI:1093925802
Name:NEELY, NICARA MICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NICARA
Middle Name:MICHELLE
Last Name:NEELY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 BAY OAK CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-4247
Mailing Address - Country:US
Mailing Address - Phone:757-487-6755
Mailing Address - Fax:
Practice Address - Street 1:1521 SAMS CIR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4694
Practice Address - Country:US
Practice Address - Phone:757-646-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0203010390183500000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program