Provider Demographics
NPI:1619551462
Name:ESSENTIAL PRENATAL CARE LLC
Entity Type:Organization
Organization Name:ESSENTIAL PRENATAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-736-9615
Mailing Address - Street 1:2701 N MARTIN LUTHER KING DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2311
Mailing Address - Country:US
Mailing Address - Phone:414-246-7549
Mailing Address - Fax:
Practice Address - Street 1:2701 N MARTIN LUTHER KING DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-2311
Practice Address - Country:US
Practice Address - Phone:414-246-7549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management