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General NPI Number Information
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NPI Number | 1457671604
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Entity Type | Individual
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Provider Name | JESSICA HENMAN CNM, CPM, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 1082 CROSSWINDS CT
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City | WENTZVILLE
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State | MO
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Zip | 63385-4836
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Country | US
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Telephone | 314-944-3646
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Fax | 314-405-9464
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Provider Business Mailing Address
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Address Line | 1082 CROSSWINDS CT
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City | WENTZVILLE
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State | MO
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Zip | 63385-4836
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Country | US
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Telephone | 314-944-3646
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Fax | 314-405-9464
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 2010015977
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2024033707
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License Number State | MO
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