Individual
LAKEEA NEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3153 N PARK AVE, INDIANAPOLIS, IN 46205-3965
(317) 778-2707
Mailing address
3153 N PARK AVE, INDIANAPOLIS, IN 46205-3965
(317) 778-2707
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
—
—
302R00000X
Health Maintenance Organization
—
—
311ZA0620X
Adult Care Home Facility
—
IN
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
IN
347C00000X
Private Vehicle
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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