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Individual

JESSIE M GRASSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
4480 W SPENCER ST, APPLETON, WI 54914-9106
(920) 738-4800
(920) 738-5749
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5970

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2336
WI
363LF0000X
Family Nurse Practitioner
Primary
2336
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43999800
WI
Enumeration date
07/03/2006
Last updated
03/17/2018
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