Individual
IVY ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM
Contact information
Practice address
378 S RIDGE AVE, IDAHO FALLS, ID 83402-4115
(608) 863-1099
Mailing address
3818 E 196 N, RIGBY, ID 83442-5670
(608) 863-1099
(208) 745-5052
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
MID-154
ID
176B00000X
Midwife
Primary
MID-154
ID
Other
Enumeration date
11/15/2023
Last updated
12/17/2024
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