Healthcare Provider Details

I. General information

NPI: 1528023470
Provider Name (Legal Business Name): JULIE M. GRENZER MSN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 06/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 W. SILVER SPRING DRIVE
MILWAUKEE WI
53216
US

IV. Provider business mailing address

2555 N. DR. MARTIN LUTHER KING DRIVE
MILWAUKEE WI
53212
US

V. Phone/Fax

Practice location:
  • Phone: 414-769-3900
  • Fax: 414-372-7289
Mailing address:
  • Phone: 414-372-8080
  • Fax: 414-372-7289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number148783-032
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: