Provider Demographics
NPI:1053682062
Name:SWIFT, EMMA MARIE (LM CPM)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:MARIE
Last Name:SWIFT
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 N BLACKHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3303
Mailing Address - Country:US
Mailing Address - Phone:608-232-5436
Mailing Address - Fax:855-286-5882
Practice Address - Street 1:521 N BLACKHAWK AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3303
Practice Address - Country:US
Practice Address - Phone:608-232-5436
Practice Address - Fax:855-286-5882
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54049176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife