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General NPI Number Information
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NPI Number | 1457136863
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Entity Type | Organization
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Legal Business Name | ESSENTIAL WOMENS WELLNESS
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 3316 1/2 4TH ST STE 4B
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City | LEWISTON
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State | ID
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Zip | 83501-4460
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Country | US
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Telephone | 208-413-7279
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Fax |
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Provider Business Mailing Address
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Address Line | 3316 1/2 4TH ST STE 4B
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City | LEWISTON
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State | ID
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Zip | 83501-4460
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Country | US
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Telephone | 208-413-7279
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY E ROGERS
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Credential | CNM
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Telephone | 208-413-7279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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