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General NPI Number Information
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NPI Number | 1013800135
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Entity Type | Organization
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Legal Business Name | FRANCES CIRCLE OF LIFE PNCC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 6150 W FOND DU LAC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53218-5600
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Country | US
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Telephone | 414-408-4262
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Fax |
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Provider Business Mailing Address
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Address Line | 6150 W FOND DU LAC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53218-5600
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Country | US
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Telephone | 414-408-4262
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DEBRA ANN WATFORD
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Credential |
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Telephone | 414-408-4262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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