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General NPI Number Information
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NPI Number | 1255141024
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Entity Type | Individual
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Provider Name | MICKAYLA D NEIBERT NP
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Gender | Female
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 851 LEONARD FULGHUM DR STE 201
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-3793
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Country | US
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Telephone | 843-884-5133
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Fax |
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Provider Business Mailing Address
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Address Line | 106 ALWYN BLVD
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City | SUMMERVILLE
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State | SC
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Zip | 29485-4064
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Country | US
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Telephone | 540-683-0520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 28141
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License Number State | SC
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