Individual
MRS. BROOKE WOOTEN GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
205 BODEN WAY, GREENSBORO, NC 27405-8296
(362) 097-3093
Mailing address
205 BODEN WAY, GREENSBORO, NC 27405-8296
(336) 209-7309
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
247237
NC
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-152817
NC
Other
Enumeration date
01/14/2013
Last updated
03/04/2021
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