Individual
KATIE R NEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
430 W BROAD ST, MONTICELLO, MS 39654-7723
(601) 587-4492
Mailing address
430 W BROAD ST, MONTICELLO, MS 39654-7723
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1316962590
MS
363LF0000X
Family Nurse Practitioner
1316962590
MS
Other
Enumeration date
10/07/2021
Last updated
03/19/2025
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