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NPI Code Detail

MEDICARE: MARY ANN NEELEY PHD, FNP, RN

MEDICARE: MARY ANN NEELEY PHD, FNP, RN
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
1363LF0000XFamily Nurse Practitioner536403TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659349629
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ANN NEELEY PHD, FNP, RN
Provider Business Mailing Address
First Line : 34319 FULSHEAR FARMS RD
Second Line :
City : FULSHEAR
State : TX
Zip : 77441-4334
Country : US
Telephone Number : 281-533-0529
Fax Number :
Provider Business Practice Location Address
First Line : 400 AUSTIN ST
Second Line :
City : RICHMOND
State : TX
Zip : 77469-4406
Country : US
Telephone Number : 281-342-1746
Fax Number : 281-342-3832
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 12/15/2010

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