Provider Demographics
NPI:1124748843
Name:NEALEY, VINCENT COLLIN (DNP)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:COLLIN
Last Name:NEALEY
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 ALPINE PL APT 303
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2691
Mailing Address - Country:US
Mailing Address - Phone:513-702-2065
Mailing Address - Fax:
Practice Address - Street 1:CLINIC #7790
Practice Address - Street 2:947 CINCINNATI BATAVIA PIKE
Practice Address - City:CINCINNATI,
Practice Address - State:OH
Practice Address - Zip Code:45245-1303
Practice Address - Country:US
Practice Address - Phone:513-943-2801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.395460163W00000X
OHAPRN.CNP.0031667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse