Provider Demographics
NPI:1568186591
Name:PERRY, KALEIGH YVONNE (CPM, LM)
Entity Type:Individual
Prefix:MS
First Name:KALEIGH
Middle Name:YVONNE
Last Name:PERRY
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25995 LON DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:ID
Mailing Address - Zip Code:83660-7217
Mailing Address - Country:US
Mailing Address - Phone:208-914-1326
Mailing Address - Fax:
Practice Address - Street 1:25995 LON DAVIS RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:ID
Practice Address - Zip Code:83660-7217
Practice Address - Country:US
Practice Address - Phone:208-914-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMID-141176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife