Healthcare Provider Details

I. General information

NPI: 1043132418
Provider Name (Legal Business Name): PAMELENA D GRIER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E ENTERPRISE AVE STE 333
APPLETON WI
54913-7889
US

IV. Provider business mailing address

2800 E ENTERPRISE AVE STE 333
APPLETON WI
54913-7889
US

V. Phone/Fax

Practice location:
  • Phone: 414-240-9400
  • Fax:
Mailing address:
  • Phone: 414-240-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1118381-30
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number1118381-30
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number1118381-30
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number1118381-30
License Number StateWI
# 5
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1118381-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: