Individual
JESSICA A GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
710 RIVERSIDE DR, WAUPACA, WI 54981-1941
(715) 256-3000
(715) 256-3028
Mailing address
710 RIVERSIDE DR, WAUPACA, WI 54981-1941
(715) 256-3000
(715) 256-3028
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
14159
WI
Other
Enumeration date
06/30/2023
Last updated
07/13/2023
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