Individual
KATIE M NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3716 DARTMOUTH PL, WEST LAFAYETTE, IN 47906-8752
(317) 750-8702
Mailing address
3716 DARTMOUTH PL, WEST LAFAYETTE, IN 47906-8752
(317) 750-8702
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71007561A
IN
363LF0000X
Family Nurse Practitioner
28218849A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001130557
ANTHEM
—
01
—
14140712
CAQH
—
05
—
300008702
—
IN
Enumeration date
08/09/2017
Last updated
06/07/2024
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