Provider Demographics
NPI:1144769027
Name:MCNEELY, JEANMARIE G (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JEANMARIE
Middle Name:G
Last Name:MCNEELY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Other - First Name:
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Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-301-8707
Mailing Address - Fax:310-301-8751
Practice Address - Street 1:2780 SKYPARK DR STE 125
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7528
Practice Address - Country:US
Practice Address - Phone:310-530-8013
Practice Address - Fax:310-530-8014
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2022-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95047647363LA2100X
CA95006152363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care