Leslee A Granke, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

133-033 Issued in WI

Practice address

15397 State Highway 32
Lakewood, WI 54138

Phone

(715) 276-6321

Fax

(715) 276-1428

NPI assigned

Aug 20, 2006

Last updated

Oct 28, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540684800000",
    "number": "1407961402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15954 RIVERS EDGE DR STE 304",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548437894",
            "telephone_number": "715-634-2541",
            "fax_number": "715-598-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15397 STATE HIGHWAY 32",
            "city": "LAKEWOOD",
            "state": "WI",
            "postal_code": "54138",
            "telephone_number": "715-276-6321",
            "fax_number": "715-276-1428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2414 Kohler Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "53081",
            "country_code": "US",
            "telephone_number": "920-457-4461",
            "fax_number": "920-459-1447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANKE",
        "first_name": "LESLEE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "133-033",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "75395",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43836400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Muhammad Saadah Diab, DMD
• Gary A Donaldson, RPH
• Blake J Edinger, D.D.S.
• Rene A Farah, R.D.H.
• Christi Fowler, MS, NCC, LPC
• Ashlei Elaine Guarisco, R.D.H.
• Gisela Gunderson
• Habeck Chiropractic Center, LLC
• Adam Robert Habeck, D.C.
• Jennifer Halverson

• Nurse Practitioner in Lakewood, WI
• Providers in Lakewood, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.