Healthcare Provider Details

I. General information

NPI: 1376789792
Provider Name (Legal Business Name): AMY HOWELL WREN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 10/26/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2341 LEWISVILLE CLEMMONS RD
CLEMMONS NC
27012-8905
US

IV. Provider business mailing address

2341 LEWISVILLE CLEMMONS RD
CLEMMONS NC
27012-8905
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-4039
  • Fax: 336-713-3288
Mailing address:
  • Phone: 336-716-4039
  • Fax: 336-713-3288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5016966
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number12851
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number544
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: