Healthcare Provider Details

I. General information

NPI: 1447899000
Provider Name (Legal Business Name): SARA BRIE EHLERS DENTEL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2019
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 E KING ST
KINGS MOUNTAIN NC
28086-3186
US

IV. Provider business mailing address

PO BOX 96860
CHARLOTTE NC
28296-6860
US

V. Phone/Fax

Practice location:
  • Phone: 704-734-4550
  • Fax: 704-734-4540
Mailing address:
  • Phone: 704-734-4550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012660
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5012660
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: