Healthcare Provider Details

I. General information

NPI: 1568397073
Provider Name (Legal Business Name): GENEVIEVE NICOLE STEVENS CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 DEWEY ST
SUN PRAIRIE WI
53590-2321
US

IV. Provider business mailing address

199 DEWEY ST
SUN PRAIRIE WI
53590-2321
US

V. Phone/Fax

Practice location:
  • Phone: 608-239-3219
  • Fax:
Mailing address:
  • Phone: 608-239-3219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number638-49
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: