Individual
GRACE FAULLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3807 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(262) 687-4011
Mailing address
W148N8107 UNIVERSITY DR, MENOMONEE FALLS, WI 53051-3825
(262) 719-3897
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
14463
WI
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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