Individual
MS. KRISTIN M. GRANLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF GASTROENTEROLOGY, MILWAUKEE, WI 53226-3522
(414) 955-6853
(414) 955-6214
Mailing address
9200 W WISCONSIN AVE, DIVISION OF GASTROENTEROLOGY, MILWAUKEE, WI 53226-3522
(414) 955-6853
(414) 955-6214
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2282
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538322151
—
WI
Enumeration date
07/03/2008
Last updated
02/25/2014
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