Most Relevant Information
Provider Data
| NPI Number: | 1003009010 |
| Provider Name: | TRACY BLAIR WANDTKE HERRMANN CNM |
| Entity Type: | Individual |
| Taxonomy Code: | 367A00000X |
| Specialty: | Advanced Practice Midwife |
| License Number: | 148811-032 |
Most Important Dates
| Enumeration Date: | 08/22/2007 |
| Last Updated: | 04/05/2017 |
Provider Practice Location
1032 S CESAR E CHAVEZ DR
MILWAUKEE
WI
532042203
Practice Location Phone/Fax
| Phone: | 4146721353 |
| Fax: | 4146724265 |
Provider Mailing Location
1032 S CESAR E CHAVEZ DR
MILWAUKEE
WI
532042203
Provider Mailing Phone/Fax
| Phone: | 4146721353 |
| Fax: | 4146724265 |