Healthcare Provider Details

I. General information

NPI: 1073452777
Provider Name (Legal Business Name): PAMELA LYNN WRENCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9861 BROKEN LAND PKWY STE 100
COLUMBIA MD
21046-3031
US

IV. Provider business mailing address

3419 MERLE DR
WINDSOR MILL MD
21244-3666
US

V. Phone/Fax

Practice location:
  • Phone: 667-230-5316
  • Fax:
Mailing address:
  • Phone: 667-230-5316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR147671
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: