Healthcare Provider Details

I. General information

NPI: 1770614562
Provider Name (Legal Business Name): VALARIE MCNEELY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5822 WOODSTOCK ST
SHAWNEE KS
66218-8400
US

IV. Provider business mailing address

5822 WOODSTOCK ST
SHAWNEE KS
66218-8400
US

V. Phone/Fax

Practice location:
  • Phone: 913-825-1391
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number14-01377
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number14-01377
License Number StateKS

VIII. Authorized Official

Name: VALARIE LEE MCNEELY
Title or Position: PHYSICAL THERAPY ASSISTANT
Credential: CPTA
Phone: 913-825-1931