Provider Demographics
NPI:1770846065
Name:NEAL, DONNA DAUTERIVE (R N)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:DAUTERIVE
Last Name:NEAL
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15481 W. CLUB DELUXE RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403
Mailing Address - Country:US
Mailing Address - Phone:985-543-4136
Mailing Address - Fax:985-543-4037
Practice Address - Street 1:15481 W. CLUB DELUXE RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-543-4136
Practice Address - Fax:985-543-4037
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN050791163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health