Healthcare Provider Details

I. General information

NPI: 1063968956
Provider Name (Legal Business Name): JANELLE BRUBAKER ALIER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 NEW ALTAMONT TER
GREENVILLE SC
29609-6234
US

IV. Provider business mailing address

5 NEW ALTAMONT TER
GREENVILLE SC
29609-6234
US

V. Phone/Fax

Practice location:
  • Phone: 864-999-0350
  • Fax: 864-752-1735
Mailing address:
  • Phone: 864-787-1774
  • Fax: 864-752-1735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number20491
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: