Provider Demographics
NPI:1629303292
Name:THE NATURAL ALTERNATIVE MIDWIVERY PRACTICE LLC
Entity Type:Organization
Organization Name:THE NATURAL ALTERNATIVE MIDWIVERY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:PENWELL
Authorized Official - Suffix:
Authorized Official - Credentials:CPM
Authorized Official - Phone:208-284-9394
Mailing Address - Street 1:2829 N CITRUS PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-5185
Mailing Address - Country:US
Mailing Address - Phone:208-284-9394
Mailing Address - Fax:208-629-5614
Practice Address - Street 1:2829 N CITRUS PL
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-5185
Practice Address - Country:US
Practice Address - Phone:208-284-9394
Practice Address - Fax:208-629-5614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM83069-R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty