Provider Demographics
NPI:1619510989
Name:NEAL, JANET LEE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LEE
Last Name:NEAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LEE
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:482 FALLVIEW CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-8449
Mailing Address - Country:US
Mailing Address - Phone:513-464-2615
Mailing Address - Fax:937-867-5268
Practice Address - Street 1:323 N BROAD ST
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-4934
Practice Address - Country:US
Practice Address - Phone:937-318-8103
Practice Address - Fax:937-867-5268
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-19
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025836363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health