Individual
MS. LESLEE A GRANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
15397 STATE HIGHWAY 32, LAKEWOOD, WI 54138
(715) 276-6321
(715) 276-1428
Mailing address
15954 RIVERS EDGE DR STE 304, HAYWARD, WI 54843-7894
(715) 634-2541
(715) 598-4881
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
75395
WI
363L00000X
Nurse Practitioner
Primary
133-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43836400
—
WI
Enumeration date
08/20/2006
Last updated
10/28/2018
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