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General NPI Number Information
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NPI Number | 1346047164
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Entity Type | Organization
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Legal Business Name | MOMMYS BEAUTIFUL SUNRISE INC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 8430 W CAPITOL DR STE 3025
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City | MILWAUKEE
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State | WI
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Zip | 53222-1846
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Country | US
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Telephone | 262-457-9815
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Fax |
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Provider Business Mailing Address
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Address Line | 2656 N TEUTONIA AVE # 6566
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City | MILWAUKEE
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State | WI
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Zip | 53206-9998
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Country | US
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Telephone | 262-457-9815
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Fax |
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Authorized Official
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Title or Position | EXECUTOR DIRECTOR
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Name | DR. SHANICE BAQUET
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Credential | HOLISTIC PR
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Telephone | 262-457-9815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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