Jennifer Brooke Prudhomme, CPM-TN

Primary specialty

MidwifeTaxonomy code 176B00000X

License

MW61315250 Issued in WA

Practice address

24920 104TH Ave SE
Kent, WA 98030-6443

Phone

(253) 876-3939

Fax

(253) 876-3940

NPI assigned

Apr 30, 2020

Last updated

Aug 20, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Brooke Prudhomme-Graber Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memphis Center for Reproductive Health

  • Obstetrics & Gynecology Physician
  • Memphis, TN
  • NPI 1427370600
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1558982553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 POWELL AVE SW",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572908",
            "telephone_number": "425-277-1311",
            "fax_number": "425-277-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24920 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980306443",
            "telephone_number": "253-876-3939",
            "fax_number": "253-876-3940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381047278",
            "country_code": "US",
            "telephone_number": "901-274-3550",
            "fax_number": "901-274-3551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "144 N Bellevue Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381047201",
            "country_code": "US",
            "telephone_number": "901-274-3550",
            "fax_number": "901-274-3551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUDHOMME",
        "first_name": "JENNIFER",
        "middle_name": "BROOKE",
        "credential": "CPM-TN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "WA",
            "license": "MW61315250",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "TN",
            "license": "96",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PRUDHOMME-GRABER",
            "middle_name": "BROOKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Puget Sound Regional Fire Authority

• Midwife in Kent, WA
• Providers in Kent, WA by specialty
• Midwife in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.