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NPI Code Detail

MEDICARE: MISS JILLIAN MARIE O'GRADY APNP

MEDICARE: MISS JILLIAN MARIE O'GRADY APNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner6651-33WI
2363L00000XNurse Practitioner6651-33WI

General Provider Information

NPI Number : 1821467986
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JILLIAN MARIE O'GRADY APNP
Provider Business Mailing Address
First Line : 514 RIVERVIEW AVE
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-3631
Country : US
Telephone Number : 262-548-7666
Fax Number : 262-970-6696
Provider Business Practice Location Address
First Line : 514 RIVERVIEW AVE
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-3631
Country : US
Telephone Number : 262-548-7666
Fax Number : 262-970-6696
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2015
Last Update Date : 12/11/2025

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Practice Location Address:
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1124045570 — DANIELLE RENEE BIRDEAU LPC
Practice Location Address:
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