Individual
MRS. MIRANDA G GRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC HEMATOLOGY/ONCOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-4850
(414) 266-3682
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC HEMATOLOGY/ONCOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-4850
(414) 266-3682
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
154386
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609017425
—
WI
Enumeration date
03/09/2009
Last updated
11/21/2013
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