Provider Demographics
NPI:1205137213
Name:MOHR, JENNIFER ANNE HAMBLETT (RN, CNM)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE HAMBLETT
Last Name:MOHR
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12303 NE 130TH LN
Mailing Address - Street 2:SUITE 225
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3099
Mailing Address - Country:US
Mailing Address - Phone:206-679-6280
Mailing Address - Fax:
Practice Address - Street 1:12303 NE 130TH LN
Practice Address - Street 2:SUITE 225
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3099
Practice Address - Country:US
Practice Address - Phone:206-679-6280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-07
Last Update Date:2015-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000347367A00000X
WAAP60172998367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife