Provider Demographics
NPI:1821298076
Name:HAMANN, JOLENE M (CNM, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:M
Last Name:HAMANN
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 GALLOPING GOOSE WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-2915
Mailing Address - Country:US
Mailing Address - Phone:719-323-3865
Mailing Address - Fax:719-434-9777
Practice Address - Street 1:9475 BRIAR VILLAGE PT STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7902
Practice Address - Country:US
Practice Address - Phone:719-323-3865
Practice Address - Fax:719-434-9777
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1627896163W00000X
IL041325744163W00000X
IL209007662176B00000X, 363L00000X, 363LW0102X
COAPN.0991275-CNM363L00000X, 363LX0001X, 363LW0102X, 367A00000X, 363L00000X
IL209.007662363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28020219Medicaid