# MATUSHKA OLGA MICHAEL MATERNITY ASSOCIATES, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487140265
- **Authorized official:** KELLIE NORTHAM CNM (CEO)
- **Authorized official phone:** (712) 828-0234

## Contact information

- **Practice address:** 116 18TH AVE S, NAMPA, ID 83651-4841
- **Practice address phone:** (208) 639-2700
- **Practice address fax:** (208) 639-2736
- **Mailing address:** 919 13TH AVE S, NAMPA, ID 83651-4618
- **Mailing address phone:** (712) 828-0234
- **Mailing address fax:** (208) 965-8789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | CNM81-A | ID | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/05/2018
- **Last updated:** 11/04/2024