Provider Demographics
NPI:1306386784
Name:NEAL, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
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 1:2113 GOVERNMENT ST STE K2
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3949
Mailing Address - Country:US
Mailing Address - Phone:228-875-9250
Mailing Address - Fax:228-875-9205
Practice Address - Street 1:2113 GOVERNMENT ST STE K2
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3949
Practice Address - Country:US
Practice Address - Phone:228-875-9250
Practice Address - Fax:228-875-9205
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist