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NPI Code Detail

MEDICARE: CINDY GRISWOLD NP

MEDICARE:   CINDY  GRISWOLD  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner97395WI

General Provider Information

NPI Number : 1033379888
Entity Type Code : Individual
Provider Name (Legal Business Name) : CINDY GRISWOLD NP
Provider Business Mailing Address
First Line : 100 COUNTY ROAD B
Second Line :
City : SHAWANO
State : WI
Zip : 54166-7072
Country : US
Telephone Number : 715-524-2161
Fax Number :
Provider Business Practice Location Address
First Line : 370 S MAIN ST
Second Line :
City : CLINTONVILLE
State : WI
Zip : 54929-1632
Country : US
Telephone Number : 715-823-5161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2008
Last Update Date : 06/16/2008

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Directions to “ CINDY GRISWOLD NP” Practice Location

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