Healthcare Provider Details

I. General information

NPI: 1447614250
Provider Name (Legal Business Name): DE'AMBER JHRAI NEAL AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3404 W SYLVANIA AVE
TOLEDO OH
43623-4467
US

IV. Provider business mailing address

4732 VENTURA DR
TOLEDO OH
43615-6134
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-9362
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0035979
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: