Healthcare Provider Details

I. General information

NPI: 1679310171
Provider Name (Legal Business Name): ERIN M. CASSIDENTE CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E CLARKE ST
MILWAUKEE WI
53212-3007
US

IV. Provider business mailing address

W142N5030 GOLDEN FIELDS DR
MENOMONEE FALLS WI
53051-6988
US

V. Phone/Fax

Practice location:
  • Phone: 414-795-6302
  • Fax: 844-972-1548
Mailing address:
  • Phone: 414-795-6302
  • Fax: 844-972-1548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number558-49
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: