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Individual

JUDITH A GRESKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4567
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000359276
ANTHEM
OH
05
2384263
OH
01
344428256101
CARESOURCE
OH
05
4665356
MI
Enumeration date
07/14/2005
Last updated
01/11/2018
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