| Doctor Name: | KELLY WYNN NEIHEISER |
| NPI Number: | 1174747802 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 24374 |
| Business Practice Address: | 1296 Avgik Street Barrow, AK - 997231496 |
| Business Phone Number: | 9078529321 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1496, BARROW |
| State: | AK |
| Postal Code: | 997231496 |
| Phone Number: | 9078529321 |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WX0003X |
| License Number: | 24374 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Obstetric, Inpatient |
| Taxonomy Definition: | |