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General NPI Number Information
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NPI Number | 1780014753
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Entity Type | Organization
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Legal Business Name | BOISE WOMENS HEALTH & BIRTH CENTER
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 1502 W FRANKLIN ST
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City | BOISE
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State | ID
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Zip | 83702-4028
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Country | US
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Telephone | 208-639-2700
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Fax | 208-639-2736
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Provider Business Mailing Address
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Address Line | 1502 W FRANKLIN ST
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City | BOISE
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State | ID
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Zip | 83702-4028
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Country | US
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Telephone | 208-639-2700
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Fax | 208-639-2736
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Authorized Official
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Title or Position | OWNER
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Name | CHARLOTTE WILKES
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Credential | CNM
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Telephone | 208-639-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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