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General NPI Number Information
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NPI Number | 1598394967
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Entity Type | Organization
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Legal Business Name | MOMS FIRST PRENATAL CARE AGENCY LLC
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 2229 W FINN PL
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City | MILWAUKEE
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State | WI
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Zip | 53206-1847
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Country | US
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Telephone | 414-256-1301
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Fax | 414-256-1304
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Provider Business Mailing Address
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Address Line | 3864 N MORRIS BLVD
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City | SHOREWOOD
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State | WI
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Zip | 53211-2218
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Country | US
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Telephone | 262-424-4581
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | KATELYNNE INDEPENDENCE KLEIN
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Credential | RN
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Telephone | 414-303-9356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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