Provider Demographics
NPI:1386297935
Name:FAMILY TREE MIDWIFERY, INC.
Entity type:Organization
Organization Name:FAMILY TREE MIDWIFERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-283-2684
Mailing Address - Street 1:1844 W GLADE CREEK ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-4310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1844 W GLADE CREEK ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-4310
Practice Address - Country:US
Practice Address - Phone:208-283-2684
Practice Address - Fax:208-908-7805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
1134406143OtherNPI
1922662121OtherNPI