Individual
KIMBERLY L GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC MSN FNP
Contact information
Practice address
3807 SPRING ST, RACINE, WI 53405-1667
(262) 687-8282
(262) 687-6737
Mailing address
3807 SPRING ST, RACINE, WI 53405
(262) 687-8282
(262) 687-6737
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
106-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43839000
—
WI
Enumeration date
10/04/2005
Last updated
09/22/2010
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