Individual
JILL M GREVENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
999 N 92ND ST, PEDIATRIC SPECIAL NEEDS, MILWAUKEE, WI 53226-4875
(414) 337-7158
(414) 266-2926
Mailing address
999 N 92ND ST, PEDIATRIC SPECIAL NEEDS, MILWAUKEE, WI 53226-4875
(414) 337-7158
(414) 266-2926
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
147817
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124337043
—
WI
Enumeration date
09/27/2010
Last updated
07/29/2013
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