Individual
MS. THERESE MARIE O'GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
W1007 VIOLET RD, GENOA CITY, WI 53128-1666
(262) 215-8747
(262) 295-8338
Mailing address
PO BOX 939, PELL LAKE, WI 53157-0939
(262) 215-8747
(262) 295-8338
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.190108
IL
163W00000X
Registered Nurse
Primary
86757-030
WI
Other
Enumeration date
09/12/2013
Last updated
10/08/2013
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