Provider Demographics
NPI:1487012464
Name:GIESLER-DAGWER, MAKAYLA JEAN (LM, CPM)
Entity Type:Individual
Prefix:MRS
First Name:MAKAYLA
Middle Name:JEAN
Last Name:GIESLER-DAGWER
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 1:2190 DALY DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-4411
Mailing Address - Country:US
Mailing Address - Phone:920-784-7046
Mailing Address - Fax:
Practice Address - Street 1:2190 DALY DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4411
Practice Address - Country:US
Practice Address - Phone:920-784-7046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI173-49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife