Provider Demographics
NPI:1508211541
Name:ASIEDU, EUNICE (CNM)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:ASIEDU
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W CAPITOL DR STE 301
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-3328
Mailing Address - Country:US
Mailing Address - Phone:414-964-9018
Mailing Address - Fax:404-294-1558
Practice Address - Street 1:210 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-1123
Practice Address - Country:US
Practice Address - Phone:414-906-5306
Practice Address - Fax:414-906-4533
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367A00000X
GARN218856367A00000X
WI148908367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN258997OtherADVANCED PRACTICE-CNM