Healthcare Provider Details

I. General information

NPI: 1780150284
Provider Name (Legal Business Name): MRS. WHITNEY KIBLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 N 108TH PL
WAUWATOSA WI
53226-4253
US

IV. Provider business mailing address

N99W16152 NORTHWAY
GERMANTOWN WI
53022-5026
US

V. Phone/Fax

Practice location:
  • Phone: 414-231-9640
  • Fax:
Mailing address:
  • Phone: 253-222-1562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number202-049
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: