MEDICARE: KATY SKARLATOS CPM

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
1	176B00000X	Midwife	161-49	WI

General Provider Information

NPI Number	:	1336531359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATY SKARLATOS CPM

Provider Business Mailing Address
First Line	:	530 N 108TH PL STE 100
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-4253
Country	:	US
Telephone Number	:	414-617-3177
Fax Number	:	414-375-2048

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	:	414-617-3177
Fax Number	:	414-375-2048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2015
Last Update Date	:	10/28/2024

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Directions to “ KATY SKARLATOS CPM” Practice Location

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