Individual
MIKAYLA ANN BRENEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM
Contact information
Practice address
W2086 CLEARVIEW DR, MONTELLO, WI 53949-9406
(920) 229-7792
Mailing address
W2086 CLEARVIEW DR, MONTELLO, WI 53949-9406
(920) 229-7792
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
51-049
WI
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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