Provider Demographics
NPI:1558996298
Name:NEAL, MICHELLE A
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
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 1:67 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:UNITY
Mailing Address - State:ME
Mailing Address - Zip Code:04988-3423
Mailing Address - Country:US
Mailing Address - Phone:207-465-6508
Mailing Address - Fax:
Practice Address - Street 1:67 CLARK RD
Practice Address - Street 2:
Practice Address - City:UNITY
Practice Address - State:ME
Practice Address - Zip Code:04988-3423
Practice Address - Country:US
Practice Address - Phone:207-465-6508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide