Provider Demographics
NPI:1679187207
Name:NEAL, LAURA JEANNINE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JEANNINE
Last Name:NEAL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11399 KELLY LN
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-8643
Mailing Address - Country:US
Mailing Address - Phone:870-718-1358
Mailing Address - Fax:
Practice Address - Street 1:11399 KELLY LN
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-8643
Practice Address - Country:US
Practice Address - Phone:870-718-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR213271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily