Provider Demographics
NPI:1790490175
Name:GREILINGER, VICTORIA LENORE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LENORE
Last Name:GREILINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LONE OAK LN
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-2600
Mailing Address - Country:US
Mailing Address - Phone:262-224-0306
Mailing Address - Fax:
Practice Address - Street 1:110 LONE OAK LN
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-2600
Practice Address - Country:US
Practice Address - Phone:262-670-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7084-23363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical