| NPI | 1790823375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON R KELLEY Administrative Director 208-343-2079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QB0400X Clinic/Center Birthing |
| Additional Taxonomies | 163WL0100X Registered Nurse Lactation Consultant |
| 176B00000X Midwife | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2025-06-17 |