Mary Beth Neeley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R850198 Issued in MS

Practice address

2770 3Rd Ave
Suite 350 Lake Charles Memorial Hospital Internal Medic
Lake Charles, LA 70601

Phone

(337) 494-6800

Fax

(337) 494-6811

NPI assigned

Mar 26, 2007

Last updated

Sep 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1790803278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122539",
            "address_2": "DEPT 2539",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122539",
            "telephone_number": "337-494-2919",
            "fax_number": "337-494-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 3RD AVE",
            "address_2": "SUITE 350 LAKE CHARLES MEMORIAL HOSPITAL INTERNAL MEDIC",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70601",
            "telephone_number": "337-494-6800",
            "fax_number": "337-494-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELEY",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN099890",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R850198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ryan Robert Nelson
• Kyle Patrick Nester, M.D.

• Family Nurse Practitioner in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.