Provider Demographics
NPI:1891096855
Name:MCNEELY, KARLYE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:KARLYE
Middle Name:
Last Name:MCNEELY
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1802
Mailing Address - Country:US
Mailing Address - Phone:616-901-0429
Mailing Address - Fax:
Practice Address - Street 1:426 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1802
Practice Address - Country:US
Practice Address - Phone:616-879-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704222177163W00000X, 163WS0200X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool