Provider Demographics
NPI:1295252666
Name:MCNEAL, FEEKINA
Entity type:Individual
Prefix:MRS
First Name:FEEKINA
Middle Name:
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:
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 164
Mailing Address - Street 2:
Mailing Address - City:LOVEJOY
Mailing Address - State:GA
Mailing Address - Zip Code:30250-0164
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1385 BUCKINGHAM CT
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-3254
Practice Address - Country:US
Practice Address - Phone:770-472-4225
Practice Address - Fax:678-479-8758
Is Sole Proprietor?:No
Enumeration Date:2017-08-27
Last Update Date:2017-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA599832568BMedicaid