Provider Demographics
NPI:1366723371
Name:TERPENNING, JODI LYNN (CNM)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:TERPENNING
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LYNN
Other - Last Name:BREHMER TERPENNING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:1650 COCHRANE CIR # B7500
Mailing Address - Street 2:
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4613
Mailing Address - Country:US
Mailing Address - Phone:210-380-3105
Mailing Address - Fax:
Practice Address - Street 1:1650 COCHRANE CIR # B7500
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4613
Practice Address - Country:US
Practice Address - Phone:210-380-3105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0996535367A00000X
WAAP60233493367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000Medicare UPIN