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NPI Code Detail

MEDICARE: CRYSTAL LEIGH NEILL

MEDICARE: CRYSTAL LEIGH NEILL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1356143382
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL LEIGH NEILL
Provider Business Mailing Address
First Line : 501 N BRYAN AVE
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-4370
Country : US
Telephone Number : 308-532-3965
Fax Number : 308-534-4311
Provider Business Practice Location Address
First Line : 501 N BRYAN AVE
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-4370
Country : US
Telephone Number : 308-532-3965
Fax Number : 308-534-4311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2025
Last Update Date : 03/27/2025

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Directions to “ CRYSTAL LEIGH NEILL ” Practice Location

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