Healthcare Provider Details

I. General information

NPI: 1487111548
Provider Name (Legal Business Name): SHEIRA NEELY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5025 KEYSTONE BLVD
COVINGTON LA
70433-7525
US

IV. Provider business mailing address

543 KIMBERLY ANN DR
MANDEVILLE LA
70471-6712
US

V. Phone/Fax

Practice location:
  • Phone: 985-893-3395
  • Fax: 985-892-8212
Mailing address:
  • Phone: 504-881-7084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number203691
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number203691
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: