MEDICARE: UNIVERSITY NURSE-MIDWIVES, A MARQUETTE UNIVERSITY NURSING FACULTY PRAC

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	367A00000X	Advanced Practice Midwife

General Provider Information

NPI Number	:	1407870587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY NURSE-MIDWIVES, A MARQUETTE UNIVERSITY NURSING FACULTY PRAC

Provider Business Mailing Address
First Line	:	530 N. 16TH ST.
Second Line	:	ROOM 369
City	:	MILWAUKEE
State	:	WI
Zip	:	53233
Country	:	US
Telephone Number	:	414-288-3842
Fax Number	:	414-288-7739

Provider Business Practice Location Address
First Line	:	2015 E NEWPORT AVE
Second Line	:	SUITE 309
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-2984
Country	:	US
Telephone Number	:	414-961-2222
Fax Number	:	414-961-3661

Authorized Official
Title or Position	:	DEAN, MARQUETTE COLLEGE OF NURSING
Name	:	DR. LEA ACORD
Credential	:	PHD, RN
Telephone Number	:	414-288-3812

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	08/22/2020

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