Individual
CYNEDRA NEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
804 N PARKWAY, JACKSON, TN 38305-3058
(731) 423-3020
Mailing address
804 N PARKWAY, JACKSON, TN 38305-3058
(731) 423-3020
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0000051780
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4448133
—
TN
Enumeration date
12/04/2014
Last updated
12/04/2014
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