Healthcare Provider Details

I. General information

NPI: 1538619630
Provider Name (Legal Business Name): BREANNE HUSS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2199 N MERRITT CREEK LOOP
COEUR D ALENE ID
83814-4949
US

IV. Provider business mailing address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

V. Phone/Fax

Practice location:
  • Phone: 208-665-7546
  • Fax: 208-667-4607
Mailing address:
  • Phone: 208-625-5085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number54330
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: