Grissman, Tamara

Grissman, Tamara is an individual health care provider with primary practice located at 1284 N Summit Ave , Oconomowoc WI 53066-4459. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Grissman, Tamara can be contacted via phone (262) 560-3700.

Contact Information

Primary practice address
1284 N Summit Ave Oconomowoc WI 53066-4459
Phone: (262) 560-3700
Fax: (262) 560-3759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2652-023 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 2652-023 Wisconsin

Profile Details

NPI number 1093022519
LBN Legal business name Grissman, Tamara
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2010
Last updated Oct 13th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093022519 NPPES
Wisconsin MEDICAID 100011873

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