Provider Demographics
NPI:1447262878
Name:NEELEY, CHRISTINA KAY (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:KAY
Last Name:NEELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 CITY CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-8960
Mailing Address - Country:US
Mailing Address - Phone:252-338-2155
Mailing Address - Fax:
Practice Address - Street 1:1735 CITY CENTER BLVD
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3468
Practice Address - Country:US
Practice Address - Phone:252-338-2155
Practice Address - Fax:252-338-7704
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36189208000000X
NC9801418208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4255293OtherCIGNA IND PROV #
NC89126NFMedicaid
NCC7507OtherMEDCOST IND PROV #
NC126NFOtherBCBS IND PROV #
NC1228823OtherUNC IND PROV #
NC20-0109889OtherTRICARE PROVIDER #
NC1228823OtherUNC IND PROV #