Healthcare Provider Details

I. General information

NPI: 1033764675
Provider Name (Legal Business Name): ALEX AMANDA FOLEY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 10/06/2024
Certification Date: 10/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 W WISCONSIN AVE
MILWAUKEE WI
53208-3182
US

IV. Provider business mailing address

W126N6432 WILLOW CT
MENOMONEE FALLS WI
53051-8300
US

V. Phone/Fax

Practice location:
  • Phone: 414-291-2626
  • Fax:
Mailing address:
  • Phone: 414-322-5643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: