Healthcare Provider Details

I. General information

NPI: 1396253118
Provider Name (Legal Business Name): DANIELLE E GREVE APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE E WIZA

II. Dates (important events)

Enumeration Date: 01/15/2018
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 W LAYTON AVE
GREENFIELD WI
53220-4021
US

IV. Provider business mailing address

5800 W LAYTON AVE
GREENFIELD WI
53220-4021
US

V. Phone/Fax

Practice location:
  • Phone: 262-627-0314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8281
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8281-33
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number162918
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: