Mary Grace Lemmenes, APNP
Individual provider Active NPI Adult Health Nurse Practitioner · Brandon, WI
NPI 1710140488 · NPPES record last updated Jul 3, 2008
Key facts
- NPI
- 1710140488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 3188033 (WI)
- Practice address
- N4439 Meadow Rd
Brandon, WI 53919-9734 - Phone
- (920) 346-2187
- NPI assigned
- Jul 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3188033 | WI | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 3188033 | WI | Yes |
Addresses
Primary practice location
N4439 Meadow Rd
Brandon, WI 53919-9734
Mailing address
N4439 Meadow Road
Wisconsin, WI 53919
Phone (920) 346-2187
Other providers in Brandon, WI
All providers in Brandon, WI · Adult Health Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.