MEDICARE: MRS. ANDREA MARIE ROLTGEN CPM, LM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	MID-149	ID

General Provider Information

NPI Number	:	1942087010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA MARIE ROLTGEN CPM, LM

Provider Business Mailing Address
First Line	:	17632 N ADVENT LN
Second Line	:
City	:	HAUSER
State	:	ID
Zip	:	83854-5431
Country	:	US
Telephone Number	:	208-416-1701
Fax Number	:	208-216-1433

Provider Business Practice Location Address
First Line	:	17632 N ADVENT LN
Second Line	:
City	:	HAUSER
State	:	ID
Zip	:	83854-5431
Country	:	US
Telephone Number	:	208-416-1701
Fax Number	:	208-216-1433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2023
Last Update Date	:	09/12/2023

Similar Medicare Providers

1891792867 — MR. BRETT E. HANEY RPH, BCPP
Practice Location Address:

16788 W HOLLISTER HILLS DR
HAUSER, ID
83854-6588

Practice Phone: 208-773-2412
Practice Fax:

1982639878 — JENNIFER E. BUTLER PT
Practice Location Address:

9797 N GLEN HOLLOW LN
HAUSER, ID
83854-6159

Practice Phone: 208-771-3579
Practice Fax: 208-561-6194

1700944709 — CATHLEEN WESTON CPM,RN,LM
Practice Location Address:

16660 N RIGHT FORK RD
HAUSER, ID
83854-5585

Practice Phone: 208-773-9420
Practice Fax: 208-773-5776

1942368543 — MRS. TERESSA LINDA DURHAM
Practice Location Address:

11186 N HAUSER LAKE RD
HAUSER, ID
83854-5638

Practice Phone: 208-457-1515
Practice Fax:

1669002630 — MR. BRIAN A JOHNSON LPCC
Practice Location Address:

16978 W SANTIAGO CIR
HAUSER, ID
83854-8153

Practice Phone: 208-446-6940
Practice Fax:

1396449088 — BUTLER PHYSICAL THERAPY
Practice Location Address:

9797 N GLEN HOLLOW LN
HAUSER, ID
83854-6159

Practice Phone: 208-771-3579
Practice Fax:

Directions to “ MRS. ANDREA MARIE ROLTGEN CPM, LM” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.