Provider Demographics
NPI:1386241164
Name:NEAL, BECKY LYNN
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:LYNN
Last Name:NEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6332 PECK RD
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-8814
Mailing Address - Country:US
Mailing Address - Phone:330-858-1917
Mailing Address - Fax:
Practice Address - Street 1:6332 PECK RD
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-8814
Practice Address - Country:US
Practice Address - Phone:330-858-1917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide