Provider Demographics
NPI:1720350150
Name:ISLAM, TEHMINA (CPM, LM)
Entity Type:Individual
Prefix:MS
First Name:TEHMINA
Middle Name:
Last Name:ISLAM
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-4803
Mailing Address - Country:US
Mailing Address - Phone:608-445-5385
Mailing Address - Fax:866-689-5370
Practice Address - Street 1:2809 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-4803
Practice Address - Country:US
Practice Address - Phone:608-445-5385
Practice Address - Fax:866-689-5370
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52-49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife