Provider Demographics
NPI:1477959526
Name:ANDERSON, NEELY D (RN)
Entity Type:Individual
Prefix:MRS
First Name:NEELY
Middle Name:D
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 COUNTY SERVICES RD
Mailing Address - Street 2:#200
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1748
Mailing Address - Country:US
Mailing Address - Phone:615-792-4318
Mailing Address - Fax:
Practice Address - Street 1:162 COUNTY SERVICES RD
Practice Address - Street 2:#200
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1748
Practice Address - Country:US
Practice Address - Phone:615-792-4318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000108571163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice