Provider Demographics
NPI:1528177540
Name:PATEL, NEELOU M (MHNP)
Entity type:Individual
Prefix:MS
First Name:NEELOU
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:MHNP
Other - Prefix:MS
Other - First Name:NEELOU
Other - Middle Name:M
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHNP
Mailing Address - Street 1:34 MILLBRANCH RD STE 80
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1687
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34 MILLBRANCH RD STE 80
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402
Practice Address - Country:US
Practice Address - Phone:601-909-9394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR836733363LP0808X, 363LF0000X, 363LP0808X
KY5779P363L00000X
NH077621-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS9065895OtherAETNA
MS05579786Medicaid
MS9065895OtherAETNA
MS05579786Medicaid