Organization
MATUSHKA OLGA MICHAEL MATERNITY ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE NORTHAM CNM (CEO)
(712) 828-0234
Entity
Organization
Contact information
Practice address
116 18TH AVE S, NAMPA, ID 83651-4841
(208) 639-2700
(208) 639-2736
Mailing address
919 13TH AVE S, NAMPA, ID 83651-4618
(712) 828-0234
(208) 965-8789
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
CNM81-A
ID
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/05/2018
Last updated
11/04/2024
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