Provider Demographics
NPI:1649463738
Name:HOUSTON, JENNIFER KAY (CNM)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:KAY
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 HIGH FALLS RD
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-5604
Mailing Address - Country:US
Mailing Address - Phone:518-678-3154
Mailing Address - Fax:518-678-5551
Practice Address - Street 1:1081 HIGH FALLS RD
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-5604
Practice Address - Country:US
Practice Address - Phone:518-678-3154
Practice Address - Fax:518-678-5551
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000440-1176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife