Basic Information
Provider Information
NPI: 1669498739
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEATON
FirstName: MARIE
MiddleName: EILEEN
NamePrefix:  
NameSuffix:  
Credential: APRN, BC, NP
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 EAST MEDICAL CENTER DR
Address2: B1 FLOOR UNIVERSITY HOSPITAL RECP C
City: ANN ARBOR
State: MI
PostalCode: 481095030
CountryCode: US
TelephoneNumber: 7349364566
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/14/2006
LastUpdateDate: 06/25/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X4704101003MIY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X4704101003MIN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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