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NPI Code Detail

MEDICARE: AUTHENTIC MIDWIVES LLC

MEDICARE: AUTHENTIC MIDWIVES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1176B00000XMidwife
2367A00000XAdvanced Practice Midwife

General Provider Information

NPI Number : 1184449860
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTHENTIC MIDWIVES LLC
Provider Business Mailing Address
First Line : 2864 S WAUKESHA RD
Second Line :
City : WEST ALLIS
State : WI
Zip : 53227-2834
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 530 N 108TH PL STE 100
Second Line :
City : WAUWATOSA
State : WI
Zip : 53226-4253
Country : US
Telephone Number : 414-231-9640
Fax Number : 414-375-2048
Authorized Official
Title or Position : OWNER
Name : KATY SKARLATOS
Credential : CPM, LM
Telephone Number : 414-231-9640
Provider Enumeration Date : 11/18/2024
Last Update Date : 12/22/2025

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Directions to “AUTHENTIC MIDWIVES LLC ” Practice Location

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