Healthcare Provider Details

I. General information

NPI: 1700708104
Provider Name (Legal Business Name): SARAH ASHLEY JOHNSON RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S OWEN ST
ELIZABETHTOWN NC
28337-8878
US

IV. Provider business mailing address

826 SINGLETARY MILL POND RD
BLADENBORO NC
28320-8108
US

V. Phone/Fax

Practice location:
  • Phone: 910-874-9022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-323046
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: