| NPI | 1104436195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLEE JOHNSON Owner 208-497-0541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 176B00000X Midwife |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2020-11-02 |