Provider Demographics
NPI:1871722074
Name:NEELEY, RHONDA LYNN (LPN)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LYNN
Last Name:NEELEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45113-0312
Mailing Address - Country:US
Mailing Address - Phone:937-725-4322
Mailing Address - Fax:
Practice Address - Street 1:2686 STATE ROUTE 132
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45113-9628
Practice Address - Country:US
Practice Address - Phone:937-725-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.135104-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse