=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043662851
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH NEELY IVEY APRN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2016
-----------------------------------------------------
Last Update Date | 11/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1926 23RD AVE
-----------------------------------------------------
City | MERIDIAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39301-3107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 769-249-4288
-----------------------------------------------------
Fax | 844-670-3893
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1926 23RD AVE
-----------------------------------------------------
City | MERIDIAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39301-3107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 769-249-4288
-----------------------------------------------------
Fax | 844-670-3893
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 901553
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 3-001638
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------