Healthcare Provider Details

I. General information

NPI: 1003937939
Provider Name (Legal Business Name): SAKINA O'UHURU CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 SELWYN AVE UNIT 619
CHARLOTTE NC
28209
US

IV. Provider business mailing address

2820 SELWYN AVE UNIT 619
CHARLOTTE NC
28209
US

V. Phone/Fax

Practice location:
  • Phone: 704-420-0424
  • Fax: 866-308-6063
Mailing address:
  • Phone: 704-420-0424
  • Fax: 866-308-6063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF000735
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: