Provider Demographics
NPI:1023074424
Name:NEEL, KERRI I (MS FNP)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:I
Last Name:NEEL
Suffix:
Gender:F
Credentials:MS FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRICKYARD LN STE EE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1681
Mailing Address - Country:US
Mailing Address - Phone:207-305-0965
Mailing Address - Fax:207-770-5800
Practice Address - Street 1:1 BRICKYARD LN STE EE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1681
Practice Address - Country:US
Practice Address - Phone:207-305-0965
Practice Address - Fax:207-770-5800
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME041603363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
500022131OtherRAILROAD MEDICARE
279710099OtherPRIMECARE MEDICAID
010467585OtherSTANDARD TAX ID
NH40Y003577ME01OtherANTHEM BCBS NEW HAMPSHIRE
010467585OtherMACHIGONNE
010467585OtherAETNA NONHMO
ME279710099Medicaid
010467585OtherAETNA HMO
4178556OtherCIGNA HEALTHCARE
041369OtherANTHEM BCBS
P43830OtherHARVARD PILGRIM
279710099OtherPRIMECARE MEDICAID
4178556OtherCIGNA HEALTHCARE