Healthcare Provider Details

I. General information

NPI: 1154935583
Provider Name (Legal Business Name): SABRINA KELLY LEWIS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9930 KINCEY AVE STE 360
HUNTERSVILLE NC
28078-6541
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-316-4830
  • Fax: 704-316-4831
Mailing address:
  • Phone: 704-316-4830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1025
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: