MEDICARE: ALICE M PHIPPS CNM, NP

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	137177	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407966997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE M PHIPPS CNM, NP

Provider Business Mailing Address
First Line	:	7915 N BOYD WAY
Second Line	:
City	:	FOX POINT
State	:	WI
Zip	:	53217-3214
Country	:	US
Telephone Number	:	414-202-6604
Fax Number	:	414-540-6881

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	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/15/2019

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