Provider Demographics
NPI:1356406987
Name:MCNEELY-NIEVES, ALANA (OD)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:MCNEELY-NIEVES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 SEABOARD LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2930
Mailing Address - Country:US
Mailing Address - Phone:615-493-1014
Mailing Address - Fax:615-493-1035
Practice Address - Street 1:98 SEABOARD LN
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2930
Practice Address - Country:US
Practice Address - Phone:615-493-1014
Practice Address - Fax:615-493-1035
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1504905Medicaid
TN103I412900Medicare PIN