Provider Demographics
NPI:1366445884
Name:INGLESBY-SCHAEFER, SALLY REGINA (CNM)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:REGINA
Last Name:INGLESBY-SCHAEFER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 603250
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3250
Mailing Address - Country:US
Mailing Address - Phone:828-884-9111
Mailing Address - Fax:
Practice Address - Street 1:360 HOSPITAL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-0107
Practice Address - Country:US
Practice Address - Phone:828-456-9006
Practice Address - Fax:828-456-8199
Is Sole Proprietor?:No
Enumeration Date:2005-05-30
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCNM099367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife