MEDICARE: TRESSA H NEELY CRNA

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
1	367500000X	Certified Registered Nurse Anesthetist	140454	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00714332	OTHER	MO	RAILROAD
2	110375	OTHER	MO	HEALTHLINK

General Provider Information

NPI Number	:	1568603355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRESSA H NEELY CRNA

Provider Business Mailing Address
First Line	:	319 S SILVER SPRINGS RD STE A
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-6308
Country	:	US
Telephone Number	:	573-339-7185
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 S SILVER SPRINGS RD STE A
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-6308
Country	:	US
Telephone Number	:	573-339-7185
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2009
Last Update Date	:	02/26/2026

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Directions to “ TRESSA H NEELY CRNA” Practice Location

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