Individual
MRS. JANE F. GRANTHAM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3822 W OHIO AVE, MILWAUKEE, WI 53215-4048
(414) 643-7971
Mailing address
3822 W OHIO AVE, MILWAUKEE, WI 53215-4048
(414) 643-7971
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
99750-030
WI
163W00000X
Registered Nurse
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38202900
—
WI
Enumeration date
11/29/2005
Last updated
07/09/2007
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