MEDICARE: MS. GLORIA J MCGRATH 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
1	363LP0200X	Pediatric Nurse Practitioner	65447	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	008006261Z	OTHER		HUMANA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952352700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GLORIA J MCGRATH NP

Provider Business Mailing Address
First Line	:	1834 W WISCONSIN AVE STE 100
Second Line	:	MARQUETTE NEIGHBORHOOD HEALTH CENTER
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-2125
Country	:	US
Telephone Number	:	414-933-9100
Fax Number	:	414-933-9200

Provider Business Practice Location Address
First Line	:	1834 W WISCONSIN AVE STE 100
Second Line	:	MARQUETTE NEIGHBORHOOD HEALTH CENTER
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-2125
Country	:	US
Telephone Number	:	414-933-9100
Fax Number	:	414-933-9200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	12/01/2011

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