Provider Demographics
NPI:1528023470
Name:GRENZER, JULIE M (MSN, CNM)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:M
Last Name:GRENZER
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 N. DR. MARTIN LUTHER KING DRIVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212
Mailing Address - Country:US
Mailing Address - Phone:414-372-8080
Mailing Address - Fax:414-372-7289
Practice Address - Street 1:8200 W. SILVER SPRING DRIVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216
Practice Address - Country:US
Practice Address - Phone:414-769-3900
Practice Address - Fax:414-372-7289
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148783-032176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38339600Medicaid
WI38339600Medicaid