Provider Demographics
NPI:1134557911
Name:NEEL, BETH (PA-C)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:NEEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HERTFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27944-1205
Mailing Address - Country:US
Mailing Address - Phone:252-426-5711
Mailing Address - Fax:252-426-1999
Practice Address - Street 1:600 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:HERTFORD
Practice Address - State:NC
Practice Address - Zip Code:27944-1205
Practice Address - Country:US
Practice Address - Phone:252-426-5711
Practice Address - Fax:252-426-1999
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04517363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical