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Individual

AMY JANINE GRANDADAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
N1790 N WOODYARD RD, SHELL LAKE, WI 54871-7801
(715) 416-5265
Mailing address
N1790 N WOODYARD RD, SHELL LAKE, WI 54871-7801
(715) 416-5265

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
181036-30
WI

Other

Enumeration date
11/21/2022
Last updated
11/21/2022
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