=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578868451
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIMBERLY N. DELAY CPM, LM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2011
-----------------------------------------------------
Last Update Date | 09/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 33511 S LAKESHORE DR
-----------------------------------------------------
City | BURLINGTON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53105-9292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 262-977-3070
-----------------------------------------------------
Fax | 262-458-4105
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33511 S LAKESHORE DR
-----------------------------------------------------
City | BURLINGTON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53105-9292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 262-977-3070
-----------------------------------------------------
Fax | 262-458-4105
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | 48-49
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------