| Organization Name: | MAGIC VALLEY MIDWIFERY, LLC |
| NPI Number: | 1457596769 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONNIE JEAN WOLCOTT (CERTIFIED NURSE-MIDWIFE) |
| Mailing Address: | 102 E Avenue F Jerome |
| State: | ID US |
| Postal Code: | 833383133 |
| Phone Number: | 2083242778 |
| Fax Number: | 2083242778 |
| NPI Enumeration Date: | 12/16/2008 |
| NPI Last Update Date: | 12/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0005X |
| License Number: | CNM-24A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Family Planning Facility |
| Taxonomy Definition: | An abortion/family planning facility where services are provided at a fixed specific location. An Ambulatory Family Planning Facility does not provide overnight accommodations. The following procedures may be performed at an Ambulatory Family Planning Facility: abortions, laproscopy, hysterectomies, tubule ligation and other related procedures. Abortion is considered voluntary termination of pregnancy. |