Healthcare Provider Details

I. General information

NPI: 1669015954
Provider Name (Legal Business Name): CHRISTIE MERRITT SANDERS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2019
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 MEMORIAL DR
JACKSONVILLE NC
28546-6333
US

IV. Provider business mailing address

245 MEMORIAL DR
JACKSONVILLE NC
28546-6333
US

V. Phone/Fax

Practice location:
  • Phone: 910-353-4333
  • Fax: 910-353-2108
Mailing address:
  • Phone: 910-353-4333
  • Fax: 910-353-2108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM05939
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: