Healthcare Provider Details

I. General information

NPI: 1073044707
Provider Name (Legal Business Name): YOLANDA YVETTE NEAL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1744 PAYNE AVE
CLEVELAND OH
44114-2910
US

IV. Provider business mailing address

1744 PAYNE AVE
CLEVELAND OH
44114-2910
US

V. Phone/Fax

Practice location:
  • Phone: 216-651-9950
  • Fax: 216-651-9951
Mailing address:
  • Phone: 216-651-9950
  • Fax: 216-651-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN322679
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: