Healthcare Provider Details

I. General information

NPI: 1689601783
Provider Name (Legal Business Name): CARRIE ELIZABETH NEERLAND CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE ELIZABETH CHICOS CNM

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MINNESOTA PHYSICIANS 606 24TH AVENUE SOUTH, SUITE 300
MINNEAPOLIS MN
55454
US

IV. Provider business mailing address

UNIVERSITY OF MINNESOTA PHYSICIANS 420 DELAWARE STREET SE, MMC 395
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-7112
  • Fax:
Mailing address:
  • Phone: 612-626-3111
  • Fax: 612-626-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR 158206-4
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: