Healthcare Provider Details

I. General information

NPI: 1356886287
Provider Name (Legal Business Name): BABY & ME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2017
Last Update Date: 01/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W SILVER SPRING DR K200
MILWAUKEE WI
53217-5051
US

IV. Provider business mailing address

500 W SILVER SPRING DR K200
MILWAUKEE WI
53217-5051
US

V. Phone/Fax

Practice location:
  • Phone: 414-847-6315
  • Fax:
Mailing address:
  • Phone: 414-847-6315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. NIKKI MYLES
Title or Position: CASE COORDINATOR
Credential: RN
Phone: 414-702-8339