Healthcare Provider Details

I. General information

NPI: 1316585268
Provider Name (Legal Business Name): JENNA KATHERINE KOBETT CNM, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 MEDICAL PKWY
ANNAPOLIS MD
21401-7992
US

IV. Provider business mailing address

2003 MEDICAL PKWY
ANNAPOLIS MD
21401-7992
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-4400
  • Fax:
Mailing address:
  • Phone: 443-481-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR240859
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN725044
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR240859
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR240859
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP021315
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR240859
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: