Provider Demographics
NPI:1912158213
Name:GRIEBEN, CRISTINA ANDREA (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:ANDREA
Last Name:GRIEBEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 W HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-4625
Mailing Address - Country:US
Mailing Address - Phone:262-789-5014
Mailing Address - Fax:
Practice Address - Street 1:12700 W HICKORY RD
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-4625
Practice Address - Country:US
Practice Address - Phone:262-789-5014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-05
Last Update Date:2008-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI28766-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine