Provider Demographics
NPI:1760134779
Name:NEALEIGH, NICHOL DAWN
Entity Type:Individual
Prefix:
First Name:NICHOL
Middle Name:DAWN
Last Name:NEALEIGH
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 1:330 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-2225
Mailing Address - Country:US
Mailing Address - Phone:937-621-1326
Mailing Address - Fax:
Practice Address - Street 1:330 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-2225
Practice Address - Country:US
Practice Address - Phone:937-621-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care