Provider Demographics
NPI:1821379975
Name:MCNEIL, DIANNE AMANDA (RN; ANP)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:AMANDA
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:RN; ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 604
Mailing Address - Street 2:24 MILLBROOK HOLLOW
Mailing Address - City:MILLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12545-0604
Mailing Address - Country:US
Mailing Address - Phone:845-677-1207
Mailing Address - Fax:
Practice Address - Street 1:24 MILLBROOK HOLLOW
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:NY
Practice Address - Zip Code:12545-0604
Practice Address - Country:US
Practice Address - Phone:845-677-1207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265872-1163W00000X
NYF300097-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse