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Individual

MAGGIE J GROMMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP. FNP-BC

Contact information

Practice address
752 N HIGH POINT RD, MADISON, WI 53717-2236
(608) 824-4000
(608) 824-4917
Mailing address
752 N HIGH POINT RD, MADISON, WI 53717-2236
(608) 824-4000
(608) 824-4917

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11244-33
WI
363LF0000X
Family Nurse Practitioner
11244-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1831866367
WI
Enumeration date
08/24/2021
Last updated
08/19/2022
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