Basic Information
Provider Information
NPI: 1649399536
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STERN
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2906 S 20TH ST
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532153732
CountryCode: US
TelephoneNumber: 4146721353
FaxNumber: 4146724265
Practice Location
Address1: 2906 S 20TH ST
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532153732
CountryCode: US
TelephoneNumber: 4146721353
FaxNumber: 4146724265
Other Information
ProviderEnumerationDate: 03/29/2007
LastUpdateDate: 09/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X148907WIY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


Home