Provider Demographics
NPI:1174582217
Name:MCNEEL, JUDITH S (CNM)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:S
Last Name:MCNEEL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CTY X
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:WI
Mailing Address - Zip Code:53554-9532
Mailing Address - Country:US
Mailing Address - Phone:608-778-0313
Mailing Address - Fax:
Practice Address - Street 1:310 CTY X
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:WI
Practice Address - Zip Code:53554-9532
Practice Address - Country:US
Practice Address - Phone:608-778-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129424367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife