Healthcare Provider Details

I. General information

NPI: 1326905100
Provider Name (Legal Business Name): WOMENS WELLNESS COLLECTIVE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N MAIN ST UNIT 970
SPRING LAKE NC
28390-3892
US

IV. Provider business mailing address

225 N MAIN ST UNIT 970
SPRING LAKE NC
28390-3892
US

V. Phone/Fax

Practice location:
  • Phone: 915-500-9258
  • Fax:
Mailing address:
  • Phone: 915-500-9258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: AMANDA WILEY
Title or Position: CERTIFIED NURSE MIDWIFE
Credential: MSN, CNM
Phone: 915-500-9258