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General NPI Number Information
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NPI Number | 1780847160
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Entity Type | Individual
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Provider Name | MICHELLA ANN HABECK CNM
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Gender | Female
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 475 POLK ST STE F
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City | TWIN FALLS
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State | ID
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Zip | 83301-4864
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Country | US
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Telephone | 208-751-9097
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Fax | 208-736-0890
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Provider Business Mailing Address
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Address Line | 475 POLK ST STE F
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City | TWIN FALLS
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State | ID
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Zip | 83301-4864
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Country | US
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Telephone | 208-751-9097
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Fax | 208-736-0890
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | CNM1A
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License Number State | ID
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