# NEW MOON MIDWIVES

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

## Provider details

- **NPI number:** 1669124533
- **Authorized official:** METTA WEAVER (OWNER/CNM)
- **Authorized official phone:** (208) 742-4784

## Contact information

- **Practice address:** 8100 W MARIGOLD ST, BOISE, ID 83714-1301
- **Practice address phone:** (208) 742-4784
- **Mailing address:** PO BOX 140846, BOISE, ID 83714-0846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 367A00000X | Advanced Practice Midwife | — | NULL | Yes |
| 367A00000X | Advanced Practice Midwife | — | — | Yes |

## Other

- **Enumeration date:** 01/22/2022
- **Last updated:** 01/22/2022