Provider Demographics
NPI:1114017902
Name:MCDANIEL, CLAUDETTE COUGHENOUR (LMCPM)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDETTE
Middle Name:COUGHENOUR
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:LMCPM
Other - Prefix:
Other - First Name:CLAUDETTE
Other - Middle Name:LOUISE
Other - Last Name:COUGHENOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1901 CALDWELL BLVD
Mailing Address - Street 2:#1016
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651
Mailing Address - Country:US
Mailing Address - Phone:208-738-6786
Mailing Address - Fax:707-674-5512
Practice Address - Street 1:21 SOUTH HONEY DRIVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687
Practice Address - Country:US
Practice Address - Phone:208-738-6786
Practice Address - Fax:707-674-5512
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH97030003176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12280OtherLAMAZE
CA97030003OtherCERTIFIED MIDWIFE