Healthcare Provider Details

I. General information

NPI: 1508737248
Provider Name (Legal Business Name): BUMP TO BLISS PRENATAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11414 W PARK PL
MILWAUKEE WI
53224-3500
US

IV. Provider business mailing address

4451 N 36TH ST
MILWAUKEE WI
53209-5904
US

V. Phone/Fax

Practice location:
  • Phone: 414-499-9822
  • Fax:
Mailing address:
  • Phone: 414-499-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY POINTER
Title or Position: ADMINISTRATOR
Credential:
Phone: 414-499-9822