Basic Information
Provider Information
NPI: 1871008649
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCNEELY
FirstName: DAWN
MiddleName: LORRAINE
NamePrefix:  
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOWELL
OtherFirstName: DAWN
OtherMiddleName: LORRAINE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 327 1ST AVE NW
Address2:  
City: HICKORY
State: NC
PostalCode: 286016122
CountryCode: US
TelephoneNumber: 8286955900
FaxNumber: 8286954256
Practice Location
Address1: 327 1ST AVE NW
Address2:  
City: HICKORY
State: NC
PostalCode: 286016122
CountryCode: US
TelephoneNumber: 8286955900
FaxNumber: 8286954256
Other Information
ProviderEnumerationDate: 12/02/2017
LastUpdateDate: 12/07/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X144052NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health
363LP2300X144052NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
363LF0000X144052NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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