Provider Demographics
NPI:1114606274
Name:NEAL, JESSICA M
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:NEAL
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 1:717 WASHBURN ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97327-2015
Mailing Address - Country:US
Mailing Address - Phone:541-990-8819
Mailing Address - Fax:
Practice Address - Street 1:717 WASHBURN ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:OR
Practice Address - Zip Code:97327-2015
Practice Address - Country:US
Practice Address - Phone:541-990-8819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty