Provider Demographics
NPI:1700308780
Name:NEEL, KIARA (STNA)
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:
Last Name:NEEL
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 CLOVERNOLL DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-5332
Mailing Address - Country:US
Mailing Address - Phone:513-467-8650
Mailing Address - Fax:
Practice Address - Street 1:7012 CLOVERNOLL DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5349
Practice Address - Country:US
Practice Address - Phone:513-467-8650
Practice Address - Fax:513-931-6635
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2020-01-13
Deactivation Date:2018-09-06
Deactivation Code:
Reactivation Date:2020-01-13
Provider Licenses
StateLicense IDTaxonomies
OH401617190214251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health