| Lizel Ann Granada, NP-C | |
|
10256 Old Green Bay Rd Fl 3, Pleasant Prairie, WI 53158-2814 | |
| (262) 551-4160 | |
| (262) 551-4165 |
| Full Name | Lizel Ann Granada |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 10256 Old Green Bay Rd Fl 3, Pleasant Prairie, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619213618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 15297 (Wisconsin) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 209.009631 (Illinois) | Secondary |
| Entity Name | Waukegan Clinic Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306937289 PECOS PAC ID: 4284631086 Enrollment ID: O20061108000240 |
| Mailing Address | Practice Location Address |
|---|---|
| Lizel Ann Granada, NP-C 9555 76th St, Pleasant Prairie, WI 53158-1984 Ph: () - | Lizel Ann Granada, NP-C 10256 Old Green Bay Rd Fl 3, Pleasant Prairie, WI 53158-2814 Ph: (262) 551-4160 |
Lauren M Gehrig, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12500 Aurora Dr, Pleasant Prairie, WI 53158 Phone: 262-857-5000 | |
Mercedes Jean Saltou, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9555 76th St, Pleasant Prairie, WI 53158 Phone: 262-671-7050 | |
Laronda James, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9697 Saint Catherines Dr, Pleasant Prairie, WI 53158 Phone: 262-656-3338 Fax: 262-656-3368 | |
Shannon L Yow, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9555 76th St, Pleasant Prairie, WI 53158 Phone: 414-290-6720 Fax: 414-290-6755 | |
Mr. Frederick Antwi, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12500 Aurora Dr, Pleasant Prairie, WI 53158 Phone: 262-857-5000 | |
Mutsa Vollmer, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9555 76th St, Pleasant Prairie, WI 53158 Phone: 262-577-8000 | |
Jennifer Erich, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10256 Old Green Bay Rd Fl 2, Pleasant Prairie, WI 53158 Phone: 262-551-4200 |