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NPI Code Detail

MEDICARE: COURTNEY D NEAL

MEDICARE:   COURTNEY D NEAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1043617772
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY D NEAL
Provider Business Mailing Address
First Line : 555 N WOODLAWN ST STE 3105
Second Line :
City : WICHITA
State : KS
Zip : 67208-3673
Country : US
Telephone Number : 316-685-1821
Fax Number : 316-685-0768
Provider Business Practice Location Address
First Line : 555 N WOODLAWN ST STE 3105
Second Line :
City : WICHITA
State : KS
Zip : 67208-3673
Country : US
Telephone Number : 316-685-1821
Fax Number : 316-685-0768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2014
Last Update Date : 05/16/2019

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Directions to “ COURTNEY D NEAL ” Practice Location

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