Individual
HANNAH ELISABETH UNDERDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, CNM, WHNP
Contact information
Practice address
6565 W EMERALD ST, BOISE, ID 83704-8737
(208) 514-2510
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
NP1323A
ID
367A00000X
Advanced Practice Midwife
Primary
CNM69A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073952016
—
ID
Enumeration date
06/24/2013
Last updated
12/15/2023
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