Healthcare Provider Details
I. General information
NPI: 1275350282
Provider Name (Legal Business Name): ABIGAIL MCGRAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/21/2024
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 S PARK ST STE A
MADISON WI
53715-1830
US
IV. Provider business mailing address
2000 UNIVERSITY AVE
DUBUQUE IA
52001-5050
US
V. Phone/Fax
- Phone: 608-260-2900
- Fax: 608-260-2976
- Phone: 563-589-3662
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 8764-23 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: