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NPI Code Detail

MEDICARE: JACEY T GRASER NP

MEDICARE: JACEY T GRASER 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 Practitioner2133WI
2363LF0000XFamily Nurse Practitioner2133WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699874016
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACEY T GRASER NP
Provider Business Mailing Address
First Line : 1000 N OAK AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-5777
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12961 27TH AVE
Second Line :
City : CHIPPEWA FALLS
State : WI
Zip : 54729-5699
Country : US
Telephone Number : 715-738-3700
Fax Number : 715-726-1612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 07/21/2025

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