Provider Demographics
NPI:1114659745
Name:KAHRS, MALLORY B (APRN-CNM)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:B
Last Name:KAHRS
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:MALLORY
Other - Middle Name:
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-3069
Mailing Address - Fax:614-293-4780
Practice Address - Street 1:1581 DODD DR FL 4
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1257
Practice Address - Country:US
Practice Address - Phone:614-293-3069
Practice Address - Fax:614-293-4780
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.0019541367A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife