Provider Demographics
NPI:1558199224
Name:NEAL, KATHERINE ELLEN (BSN, RN, SANE P/A)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELLEN
Last Name:NEAL
Suffix:
Gender:F
Credentials:BSN, RN, SANE P/A
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:ELLEN
Other - Last Name:WAHRER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2038 WILLIAMSBURG RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3051
Mailing Address - Country:US
Mailing Address - Phone:502-395-1911
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-323-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1148028163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics