Provider Demographics
NPI:1659171106
Name:REBECCA HOLMSTEAD, LLC
Entity type:Organization
Organization Name:REBECCA HOLMSTEAD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOLMSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:208-440-7530
Mailing Address - Street 1:304 12TH AVE RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5015
Mailing Address - Country:US
Mailing Address - Phone:208-800-1948
Mailing Address - Fax:208-475-6270
Practice Address - Street 1:304 12TH AVE RD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5015
Practice Address - Country:US
Practice Address - Phone:208-800-1948
Practice Address - Fax:208-475-6270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing