Provider Demographics
NPI:1508847427
Name:NEELEY, TERRY B (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:B
Last Name:NEELEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 COPENHAGEN ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-4921
Mailing Address - Country:US
Mailing Address - Phone:941-359-9350
Mailing Address - Fax:
Practice Address - Street 1:4213 COPENHAGEN ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-4921
Practice Address - Country:US
Practice Address - Phone:941-359-9350
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1339242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily