Provider Demographics
NPI:1952352700
Name:MCGRATH, GLORIA J (NP)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:J
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1834 W WISCONSIN AVE STE 100
Mailing Address - Street 2:MARQUETTE NEIGHBORHOOD HEALTH CENTER
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-2125
Mailing Address - Country:US
Mailing Address - Phone:414-933-9100
Mailing Address - Fax:414-933-9200
Practice Address - Street 1:1834 W WISCONSIN AVE STE 100
Practice Address - Street 2:MARQUETTE NEIGHBORHOOD HEALTH CENTER
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-2125
Practice Address - Country:US
Practice Address - Phone:414-933-9100
Practice Address - Fax:414-933-9200
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2011-12-01
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Provider Licenses
StateLicense IDTaxonomies
WI65447363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
008006261ZOtherHUMANA
WI43893100Medicaid
P76026Medicare UPIN
WI43893100Medicaid
0015873601Medicare ID - Type Unspecified