Provider Demographics
NPI:1588826952
Name:NEUKIRCH, NEALY CHRISTINE (PA C)
Entity Type:Individual
Prefix:
First Name:NEALY
Middle Name:CHRISTINE
Last Name:NEUKIRCH
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 PLAEN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4453
Mailing Address - Country:US
Mailing Address - Phone:402-440-9159
Mailing Address - Fax:
Practice Address - Street 1:3056 RIVER CROSSING COURT
Practice Address - Street 2:UI HEALTHCARE RIVER CROSSING
Practice Address - City:RIVERSIDE
Practice Address - State:IA
Practice Address - Zip Code:52327-4724
Practice Address - Country:US
Practice Address - Phone:319-467-8355
Practice Address - Fax:319-467-8351
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002038363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI09230295Medicare PIN