Healthcare Provider Details

I. General information

NPI: 1154366144
Provider Name (Legal Business Name): KATHRYN NEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 STANTON RD SUITE A
DAPHNE AL
36526-4299
US

IV. Provider business mailing address

1026 STANTON RD STE. A
DAPHNE AL
36526-4299
US

V. Phone/Fax

Practice location:
  • Phone: 251-626-1182
  • Fax: 251-217-2085
Mailing address:
  • Phone: 251-626-1182
  • Fax: 251-217-2085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number24015
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: