Individual
KATHLEEN MARIE GRANGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
700 WEST AVE S, LA CROSSE, WI 54601-4783
(608) 785-0940
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(608) 785-0940
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1682773
MN
363L00000X
Nurse Practitioner
Primary
5094
WI
363L00000X
Nurse Practitioner
6104
MN
363LF0000X
Family Nurse Practitioner
A106975
IA
Other
Enumeration date
08/24/2011
Last updated
09/15/2020
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