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General NPI Number Information
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NPI Number | 1083814495
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Entity Type | Individual
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Provider Name | JESSICA HELEN DEFILIPPO C.P.M., L.M.
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 24583 TOWN HALL RD
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City | HERTEL
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State | WI
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Zip | 54845-9702
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Country | US
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Telephone | 715-468-4190
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Fax | 715-468-4193
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Provider Business Mailing Address
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Address Line | 24583 TOWN HALL RD
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City | HERTEL
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State | WI
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Zip | 54845-9702
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Country | US
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Telephone | 715-468-4190
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Fax | 715-468-4193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 25-049
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License Number State | WI
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