Provider Demographics
NPI:1376205963
Name:EHLERS, STEPHANIE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:EHLERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:MANOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NM/WHNP
Mailing Address - Street 1:600 NEW WAVERLY PL STE 310
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7404
Mailing Address - Country:US
Mailing Address - Phone:919-678-6900
Mailing Address - Fax:
Practice Address - Street 1:600 NEW WAVERLY PL STE 310
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7404
Practice Address - Country:US
Practice Address - Phone:814-762-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC807367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife