Provider Demographics
NPI:1861994378
Name:NEEL, LISA (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:NEEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BULLDOG BLVD
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1731
Mailing Address - Country:US
Mailing Address - Phone:575-746-3585
Mailing Address - Fax:
Practice Address - Street 1:301 BULLDOG BLVD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-1731
Practice Address - Country:US
Practice Address - Phone:575-746-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR50106163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool