Healthcare Provider Details

I. General information

NPI: 1760329460
Provider Name (Legal Business Name): JENNIFER MILLER WIGGINS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD APT SUITE
DURHAM NC
27705-4699
US

IV. Provider business mailing address

2709 LAWNDALE AVE
DURHAM NC
27705-4057
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-8111
  • Fax:
Mailing address:
  • Phone: 919-621-9265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: