| NPI | 1588909402 |
|---|---|
| Former Name | KELLI GRENZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 956933) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2227496) |
| 163W00000X Registered Nurse (Licence: WI 25001130) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 486) | |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2019-09-05 |