IndividualActive
Machelle Peterson, CNM
NPI 1689216095 · Advanced Practice Midwife · Tensed, ID
Provider details
- NPI number
- 1689216095
- Entity type
- Individual
- Primary specialty
- Advanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CNM
- Sex
- Female
- Sole proprietor
- Yes
- License
- 61016081 (WA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
468 Lonesome Dove Ln
Tensed, ID 83870-8387
Phone: (208) 874-3095
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 93
Tensed, ID 83870-0093
Registry dates
- Enumerated
- 2019-10-17
- Last updated
- 2023-11-06
- Certified
- 2023-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.