Healthcare Provider Details

I. General information

NPI: 1568378974
Provider Name (Legal Business Name): DR. MICHELLE GERMAINE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6331 JESSIE LN
CLEMMONS NC
27012-9887
US

IV. Provider business mailing address

6331 JESSIE LN
CLEMMONS NC
27012-9887
US

V. Phone/Fax

Practice location:
  • Phone: 336-520-5485
  • Fax:
Mailing address:
  • Phone: 336-520-5485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: