Provider Demographics
NPI:1598984395
Name:KIRKENDALL, NEELI (RN, MSN, CFNP, DNP)
Entity Type:Individual
Prefix:DR
First Name:NEELI
Middle Name:
Last Name:KIRKENDALL
Suffix:
Gender:F
Credentials:RN, MSN, CFNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:38603-0092
Mailing Address - Country:US
Mailing Address - Phone:662-224-8951
Mailing Address - Fax:662-224-6801
Practice Address - Street 1:2716 W OXFORD LOOP
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5721
Practice Address - Country:US
Practice Address - Phone:662-715-3335
Practice Address - Fax:662-715-3331
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR867739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09857307Medicaid
MS09857307Medicaid