| Doctor Name: | MIA NEURELL |
| NPI Number: | 1538144878 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | |
| Business Practice Address: | 655 7th St Bldg 700700-a 78 Mdos/sgol Robins Afb, GA - 310982227 |
| Business Phone Number: | 4783277817 |
| Business Fax Number: | 4783277816 |
| Mailing Address: | 102 Peyton Ray Ln, WARNER ROBINS |
| State: | GA |
| Postal Code: | 310882439 |
| Phone Number: | 4789889677 |
| Fax Number: | |
| NPI Enumeration Date: | 12/09/2005 |
| NPI Last Update Date: | 05/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |