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NPI Code Detail

MEDICARE: JESSICA LEE NEAL

MEDICARE: JESSICA LEE 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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1598349011
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LEE NEAL
Provider Business Mailing Address
First Line : 3380 WOODVILLE DR
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-5232
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 650 WASHINGTON AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-1042
Country : US
Telephone Number : 304-223-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2021
Last Update Date : 05/11/2021

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Directions to “ JESSICA LEE NEAL ” Practice Location

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