Provider Demographics
NPI:1891857991
Name:NEAL, MICHELE R (LM)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:R
Last Name:NEAL
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 BURLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-5745
Mailing Address - Country:US
Mailing Address - Phone:406-728-7031
Mailing Address - Fax:
Practice Address - Street 1:155 BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-5745
Practice Address - Country:US
Practice Address - Phone:406-728-7031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife