Individual
JESSICA M GRUSNICK
Active
Individual
JESSICA M GRUSNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1728
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881619583
—
WI
05
—
41992500
—
WI
Enumeration date
07/13/2006
Last updated
10/25/2022
Update your record
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