Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | CNM58 | ID |
NPI | 1073812053 |
---|---|
Provider Name | Ms. Natalie J Taylor |
First Address | Idaho Falls, ID 83404-4970 |
Second Address | Idaho Falls, ID 83404-7407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2011 |
Last Update Date | 01/09/2015 |