Provider Demographics
NPI:1073812053
Name:DANIELS, NATALIE J (CNMW)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:J
Last Name:DANIELS
Suffix:
Gender:F
Credentials:CNMW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 POTOMAC WAY
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-4970
Mailing Address - Country:US
Mailing Address - Phone:208-557-2900
Mailing Address - Fax:208-557-2910
Practice Address - Street 1:3450 POTOMAC WAY
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7407
Practice Address - Country:US
Practice Address - Phone:208-557-2900
Practice Address - Fax:208-557-2910
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCNM58176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife