Organization
MAGIC VALLEY MIDWIFERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONNIE JEAN WOLCOTT C.N.M. (CERTIFIED NURSE-MIDWIFE)
(208) 324-2778
Entity
Organization
Contact information
Practice address
102 E AVENUE F, JEROME, ID 83338-3133
(208) 324-2778
(208) 324-2778
Mailing address
276 S 360 W, JEROME, ID 83338-6037
(208) 324-2778
(208) 324-2778
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
CNM-24A
ID
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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