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NPI Code Detail

MEDICARE: STEPHANIE MCNEAL APRN

MEDICARE: STEPHANIE MCNEAL APRN
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
1363LF0000XFamily Nurse Practitioner3010568KY

General Provider Information

NPI Number : 1700333507
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE MCNEAL APRN
Provider Business Mailing Address
First Line : 5451 WOODBINE RD
Second Line :
City : ASHLAND
State : KY
Zip : 41102-8282
Country : US
Telephone Number : 443-383-9300
Fax Number :
Provider Business Practice Location Address
First Line : 2100 MILLVALE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-1604
Country : US
Telephone Number : 443-383-9300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2016
Last Update Date : 10/31/2023

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