MEDICARE: JENNA M KIRBY LM, CPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	99630	TX

General Provider Information

NPI Number	:	1568305282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA M KIRBY LM, CPM

Provider Business Mailing Address
First Line	:	267 MESA RDG
Second Line	:
City	:	DECATUR
State	:	TX
Zip	:	76234-5277
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	267 MESA RDG
Second Line	:
City	:	DECATUR
State	:	TX
Zip	:	76234-5277
Country	:	US
Telephone Number	:	313-970-0036
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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