Provider Demographics
NPI:1780026070
Name:STANTON, NEALEEN (RN)
Entity Type:Individual
Prefix:
First Name:NEALEEN
Middle Name:
Last Name:STANTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 MOUNTAINVIEW RD
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-9606
Mailing Address - Country:US
Mailing Address - Phone:509-830-4764
Mailing Address - Fax:
Practice Address - Street 1:630 MOUNTAINVIEW RD
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-9606
Practice Address - Country:US
Practice Address - Phone:509-830-4764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00053541163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse