Individual
JODI CORINNE DELAGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP, DNP
Contact information
Practice address
1130 W SUNSET DR, WAUKESHA, WI 53189-8422
(800) 389-2727
Mailing address
540 LEONA AVE, RICHLAND CENTER, WI 53581-3014
(608) 475-7146
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1271
WI
363LF0000X
Family Nurse Practitioner
4470
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43878800
—
WI
01
—
528513
UGS MEDICARE
WI
01
—
528514
UGS MEDICARE
WI
01
—
61106
DEAN HEALTH SYSTEMS
WI
Enumeration date
08/03/2005
Last updated
01/12/2021
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