Individual
JANET L. BRUNNER-GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9200 W WISCONSIN AVE STE CCC5500, MILWAUKEE, WI 53226-3522
(414) 805-0652
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-4600
(414) 805-4606
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
565
WI
363A00000X
Physician Assistant
MA001978L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790874188
—
WI
Enumeration date
10/12/2006
Last updated
03/17/2018
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