Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MID-1 | ID |
NPI | 1154649549 |
---|---|
Provider Name | Barbara Rawlings |
First Address | Bonners Ferry, ID 83805-5769 |
Second Address | Bonners Ferry, ID 83805-8380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2010 |
Last Update Date | 10/05/2010 |