Healthcare Provider Details

I. General information

NPI: 1750202990
Provider Name (Legal Business Name): ELEVATED MATERNAL PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 GOLD WAGON LN
MINT HILL NC
28227-9314
US

IV. Provider business mailing address

PO BOX 23282
CHARLOTTE NC
28227-0275
US

V. Phone/Fax

Practice location:
  • Phone: 202-491-7457
  • Fax:
Mailing address:
  • Phone: 202-491-7457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: NATISHA JEANENE SIMMS
Title or Position: CEO/FOUNDER
Credential: IBCLC,CD(DONA),PMHC
Phone: 202-491-7457