Organization
MOM2MOM PNCC
Active
Organization
MOM2MOM PNCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASIA SHAW (OWNER)
(414) 748-7919
Entity
Organization
Contact information
Practice address
7300 W DEAN RD APT 1160N, MILWAUKEE, WI 53223-0023
(414) 748-7919
Mailing address
7300 W DEAN RD APT 1160N, MILWAUKEE, WI 53223-0023
(414) 748-7919
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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