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Individual

MRS. KATHERINE DAWN GEROSIN-SHAFFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPM, LM

Contact information

Practice address
7437 W KERRY DR, BOISE, ID 83714-2080
(208) 412-4126
Mailing address
7437 W KERRY DR, BOISE, ID 83714-2080
(208) 412-4126

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MID-122
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MID-122
MIDWIFE
ID
Enumeration date
11/01/2021
Last updated
11/01/2021
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