JILL M GREVENOW NP NPI 1124337043

NPI Information

  • NPI: 1124337043
  • Provider Name: JILL M GREVENOW, NP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 999 N 92ND ST
    PEDIATRIC SPECIAL NEEDS
    MILWAUKEE, WI
    ZIP 53226
  • Phone: (414) 337-7158

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NPI Details

Jill M Grevenow, NP is a pediatrics nurse practitioner in Milwaukee, WI with 16 years of experience. Jill M Grevenow, NP NPI is 1124337043. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

999 N 92ND ST
PEDIATRIC SPECIAL NEEDS
MILWAUKEE, WI
ZIP 53226-875
Phone: (414) 337-7158
Fax: (414) 266-2926

The NPI 1124337043 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/27/2010 and was last updated on 7/29/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics147817WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11124337043MEDICAIDWISCONSIN
273601 1924MEDICARE PINWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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