Individual
MS. AMY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP, CRNA
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8700
(414) 259-1522
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8700
(414) 259-1522
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9794
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100095859
—
WI
Enumeration date
11/18/2019
Last updated
07/18/2024
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