Provider Demographics
NPI:1194389601
Name:RABINS, JENNIFER DANIELLE (CPM, LM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DANIELLE
Last Name:RABINS
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:DANIELLE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPM, LM
Mailing Address - Street 1:7598 E PALO VERDE ST
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-3255
Mailing Address - Country:US
Mailing Address - Phone:928-351-4664
Mailing Address - Fax:928-351-1788
Practice Address - Street 1:7598 E PALO VERDE ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-3255
Practice Address - Country:US
Practice Address - Phone:928-351-4664
Practice Address - Fax:928-351-1788
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM223176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife