Organization
NEELY PRIMARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA NEELY NP (OWNER)
(337) 668-4141
Entity
Organization
Contact information
Practice address
102 INDEPENDENCE BLVD, LAFAYETTE, LA 70506-6085
(337) 277-8345
Mailing address
112 KELLOGG AVE, LAFAYETTE, LA 70506-6280
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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