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Individual

KATHY LEBARON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M., C.P.M

Contact information

Practice address
297N 3855 EAST, RIGBY, ID 83442
(208) 745-7571
(208) 745-8924
Mailing address
334 RANDY DR, REXBURG, ID 83440-1712
(208) 351-1823
(208) 745-8924

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MID - 19
ID

Other

Enumeration date
01/21/2011
Last updated
01/21/2011
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