Provider Demographics
NPI:1376205963
Name:EHLERS, STEPHANIE ANNE-LAMAR (CNM)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANNE-LAMAR
Last Name:EHLERS
Suffix:
Gender:F
Credentials:CNM
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:PO BOX 603949
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3949
Mailing Address - Country:US
Mailing Address - Phone:919-350-0351
Mailing Address - Fax:919-350-7687
Practice Address - Street 1:101 COTTEN LN
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-8415
Practice Address - Country:US
Practice Address - Phone:919-235-6456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC153363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1376205963Medicaid