Provider Demographics
NPI:1710476254
Name:BROWN, HANNAH MICHAL (LM, CPM)
Entity Type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:MICHAL
Last Name:BROWN
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3018 W OVERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-3059
Mailing Address - Country:US
Mailing Address - Phone:208-813-0698
Mailing Address - Fax:208-501-8913
Practice Address - Street 1:3018 W OVERLAND RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-3059
Practice Address - Country:US
Practice Address - Phone:208-813-0698
Practice Address - Fax:208-501-8913
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMID-85176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDMID-85OtherLICENSED MIDWIFE