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Organization
MATUSHKA OLGA MICHAEL MATERNITY ASSOCIATES, INC
Active
Organization
MATUSHKA OLGA MICHAEL MATERNITY ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE NORTHAM CNM (CEO)
(712) 828-0234
Entity
Organization
Contact information
Practice address
116 18TH AVE S, NAMPA, ID 83651-4841
(208) 639-2700
(208) 639-2736
Mailing address
919 13TH AVE S, NAMPA, ID 83651-4618
(712) 828-0234
(208) 965-8789
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
CNM81-A
ID
363LF0000X
Family Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/05/2018
Last updated
11/04/2024
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