Healthcare Provider Details

I. General information

NPI: 1215866637
Provider Name (Legal Business Name): SARAH WELLS RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 BLUE RIDGE RD STE 225
RALEIGH NC
27607-6459
US

IV. Provider business mailing address

2605 BLUE RIDGE RD STE 225
RALEIGH NC
27607-6459
US

V. Phone/Fax

Practice location:
  • Phone: 984-222-8000
  • Fax: 984-222-8001
Mailing address:
  • Phone: 984-222-8000
  • Fax: 984-222-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-312438
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: