Healthcare Provider Details

I. General information

NPI: 1124937883
Provider Name (Legal Business Name): KEAURA RANISE NEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MUIRS CHAPEL RD STE 126
GREENSBORO NC
27410-6173
US

IV. Provider business mailing address

9205 STAFFORD COUNTRY LN # 9205
KERNERSVILLE NC
27284-3881
US

V. Phone/Fax

Practice location:
  • Phone: 336-638-1933
  • Fax:
Mailing address:
  • Phone: 336-995-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023318
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: