Healthcare Provider Details

I. General information

NPI: 1174005854
Provider Name (Legal Business Name): CAROLINE MICHELLE NEILL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE MICHELLE BREWER

II. Dates (important events)

Enumeration Date: 08/30/2018
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 3RD ST
GREENSBORO NC
27405-6967
US

IV. Provider business mailing address

930 3RD ST
GREENSBORO NC
27405-6967
US

V. Phone/Fax

Practice location:
  • Phone: 336-890-3200
  • Fax: 336-890-3290
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number161
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number701
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: