Individual
KENNETH NEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(541) 812-4051
Mailing address
1046 6TH AVE SW, ALBANY, OR 97321-1916
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
200640805RN
OR
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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