Individual
ALYSE SARAH POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSM, CPM, LM
Contact information
Practice address
304 12TH AVE RD, NAMPA, ID 83686-5015
(208) 800-1948
Mailing address
304 12TH AVE RD, NAMPA, ID 83686-5015
(208) 800-1948
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MID-156
ID
Other
Enumeration date
02/01/2024
Last updated
02/01/2024
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