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General NPI Number Information
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NPI Number | 1114017902
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Entity Type | Individual
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Provider Name | CLAUDETTE COUGHENOUR MCDANIEL LM CPM
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/22/2025
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Provider Practice Location Address
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Address Line | 972 S MOORSIDE AVE
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City | KUNA
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State | ID
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Zip | 83634-2586
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Country | US
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Telephone | 208-738-6786
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Fax | 707-674-5512
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Provider Business Mailing Address
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Address Line | 1901 CALDWELL BLVD #1016
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City | NAMPA
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State | ID
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Zip | 83651
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Country | US
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Telephone | 208-738-6786
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Fax | 707-674-5512
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | MID-125
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License Number State | ID
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