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General NPI Number Information
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NPI Number | 1427839943
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Entity Type | Individual
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Provider Name | LINDSAY CAROLINE GRISHAM NNP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 3801 SPRING ST
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City | MOUNT PLEASANT
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State | WI
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Zip | 53405-1667
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Country | US
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Telephone | 262-687-4011
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Fax |
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Provider Business Mailing Address
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Address Line | 3803 E KLIEFORTH AVE
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City | CUDAHY
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State | WI
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Zip | 53110-3111
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Country | US
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Telephone | 651-319-7127
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 1462333
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License Number State | WI
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