Individual
MICHAEL WAYNE GREVENGOED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
800 OAK ST, SHELDON, IA 51201-1242
(712) 324-5356
(712) 324-6515
Mailing address
603 6TH AVE, DOON, IA 51235-7726
(605) 496-1502
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A127289
IA
Other
Enumeration date
07/11/2018
Last updated
11/20/2019
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