Provider Demographics
NPI:1619018926
Name:HULBERT, DIANE M (CNM)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:HULBERT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Mailing Address - Street 1:3025 W CHERRY LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1125
Mailing Address - Country:US
Mailing Address - Phone:208-367-8550
Mailing Address - Fax:208-367-8555
Practice Address - Street 1:3025 W CHERRY LN
Practice Address - Street 2:SUITE B
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1125
Practice Address - Country:US
Practice Address - Phone:208-367-8550
Practice Address - Fax:208-367-8555
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDCNM45A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife