MEDICARE: COMPASSIONATE PRENATAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1962079541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE PRENATAL CARE

Provider Business Mailing Address
First Line	:	4177 N 47TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-1528
Country	:	US
Telephone Number	:	262-218-2877
Fax Number	:

Provider Business Practice Location Address
First Line	:	4177 N 47TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-1528
Country	:	US
Telephone Number	:	262-218-2877
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	LEESHAY NIKO EVANS
Credential	:
Telephone Number	:	262-218-2877

Provider Enumeration Date	:	06/10/2021
Last Update Date	:	06/10/2021

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Directions to “COMPASSIONATE PRENATAL CARE ” Practice Location

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