Healthcare Provider Details

I. General information

NPI: 1558996298
Provider Name (Legal Business Name): MICHELLE A NEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 CLARK RD
UNITY ME
04988-3423
US

IV. Provider business mailing address

67 CLARK RD
UNITY ME
04988-3423
US

V. Phone/Fax

Practice location:
  • Phone: 207-465-6508
  • Fax:
Mailing address:
  • Phone: 207-465-6508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: