Healthcare Provider Details

I. General information

NPI: 1396534574
Provider Name (Legal Business Name): BIRTH IN COLOR MIDWIFERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 05/03/2025
Certification Date: 05/03/2025
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:
Mailing address:
  • Phone: 612-237-2746
  • Fax: 262-500-4474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SABRINA MICHELLE FOULKS-THOMAS
Title or Position: OWNER
Credential: RN, CPM, LM, IBCLC
Phone: 612-237-2746