Individual
SHELLY RAE GRINNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
208 E OLIN AVE STE 102, MADISON, WI 53713-1413
(608) 280-3180
(608) 280-3185
Mailing address
208 E OLIN AVE STE 102, MADISON, WI 53713-1413
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
138506
WI
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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