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General NPI Number Information
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NPI Number | 1447111216
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Entity Type | Individual
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Provider Name | CAROLINE BLAIR MICHAELSON RDN, LDN
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Gender | Female
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 4525 CAMERON VALLEY PKWY STE 4100
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City | CHARLOTTE
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State | NC
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Zip | 28211-4378
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Country | US
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Telephone | 815-353-6487
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 MAINLINE BLVD APT 3201
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City | CHARLOTTE
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State | NC
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Zip | 28203-0511
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Country | US
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Telephone | 815-353-6487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L008887
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License Number State | NC
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