Healthcare Provider Details

I. General information

NPI: 1346658150
Provider Name (Legal Business Name): TRILLIUM MIDWIFERY SERVICES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 03/02/2024
Certification Date: 03/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 WISCONSIN AVE
BOSCOBEL WI
53805-1636
US

IV. Provider business mailing address

1109 WISCONSIN AVE
BOSCOBEL WI
53805-1636
US

V. Phone/Fax

Practice location:
  • Phone: 608-736-2229
  • Fax: 608-492-3524
Mailing address:
  • Phone: 608-736-2229
  • Fax: 608-492-3524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: HEATHER KRAMER
Title or Position: PARTNER
Credential: RN, CPM, LM
Phone: 608-306-0147