Provider Demographics
NPI:1093341083
Name:PRISM BIRTH SERVICES INC
Entity Type:Organization
Organization Name:PRISM BIRTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BARIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:414-253-5757
Mailing Address - Street 1:250 E WARD ST APT 315
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-1373
Mailing Address - Country:US
Mailing Address - Phone:414-708-9883
Mailing Address - Fax:
Practice Address - Street 1:5500 W VLIET ST # D
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-2120
Practice Address - Country:US
Practice Address - Phone:414-253-5757
Practice Address - Fax:414-888-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-21
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175M00000XOther Service ProvidersMidwife, LayGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1000096779Medicaid