Healthcare Provider Details

I. General information

NPI: 1881528081
Provider Name (Legal Business Name): SAMANTHA CAITLIN STANCLIFFE CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 BEALL ST
HUDSON WI
54016-2060
US

IV. Provider business mailing address

1123 SAINT CROIX HTS
HUDSON WI
54016-1409
US

V. Phone/Fax

Practice location:
  • Phone: 715-280-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License NumberCPM26061012
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: