Provider Demographics
NPI:1871998013
Name:BADGLEY, SARAH (LM ; CPM)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:BADGLEY
Suffix:
Gender:F
Credentials:LM ; CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25167 LOWER PLEASANT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WILDER
Mailing Address - State:ID
Mailing Address - Zip Code:83676-5511
Mailing Address - Country:US
Mailing Address - Phone:208-631-5338
Mailing Address - Fax:
Practice Address - Street 1:25167 LOWER PLEASANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:WILDER
Practice Address - State:ID
Practice Address - Zip Code:83676-5511
Practice Address - Country:US
Practice Address - Phone:208-631-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMID - 59176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife