Northam, Kellie Ann

Northam, Kellie Ann is an sole proprietor health care provider with primary practice located at 192 West State Street , Eagle ID 83616. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Northam, Kellie Ann can be contacted via phone (208) 807-2867.

Contact Information

Primary practice address
192 West State Street Eagle ID 83616
Phone: (208) 807-2867
Fax: (208) 639-2736
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X CNM81-A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X CNP Idaho

Profile Details

NPI number 1053650010
LBN Legal business name Northam, Kellie Ann
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 11th, 2013
Last updated May 20th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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