Healthcare Provider Details

I. General information

NPI: 1376205963
Provider Name (Legal Business Name): STEPHANIE ANNE-LAMAR EHLERS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE MANOS NM/WHNP

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COTTEN LN
HOLLY SPRINGS NC
27540-8415
US

IV. Provider business mailing address

PO BOX 603949
CHARLOTTE NC
28260-3949
US

V. Phone/Fax

Practice location:
  • Phone: 919-235-6456
  • Fax:
Mailing address:
  • Phone: 919-350-0351
  • Fax: 919-350-7687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number153
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number153
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: