Healthcare Provider Details

I. General information

NPI: 1972934388
Provider Name (Legal Business Name): SABRINA MICHELLE FOULKS-THOMAS RN, CPM, LM, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SABRINA MICHELLE FOULKS RN, CPM, LM, IBCLC

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 05/04/2025
Certification Date: 05/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N63W23217 MAIN ST UNIT 201
SUSSEX WI
53089-3204
US

IV. Provider business mailing address

W233N7735 CHESTNUT CT
SUSSEX WI
53089-1522
US

V. Phone/Fax

Practice location:
  • Phone: 612-237-2746
  • Fax: 262-500-4474
Mailing address:
  • Phone: 612-237-2746
  • Fax: 262-500-4474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number11147732
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number155-49
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: