Individual
JODY RUSSELL NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1068484
AL
367500000X
Certified Registered Nurse Anesthetist
RN161608
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891371C
—
GA
05
—
01138875
—
MS
05
—
051515690
—
AL
05
—
1771392
—
LA
01
—
2000600
UNITED HEALTHCARE
—
05
—
303304000
—
FL
01
—
51515690
BLUE CROSS BLUE SHIELD AL
AL
01
—
P00122085
RR MCARE
—
Enumeration date
04/14/2006
Last updated
07/08/2007
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