Provider Demographics
NPI:1720870207
Name:TESTA, GRANT
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:
Last Name:TESTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 FOURIER DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1960
Mailing Address - Country:US
Mailing Address - Phone:608-690-8256
Mailing Address - Fax:
Practice Address - Street 1:901 WHALEN RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1765
Practice Address - Country:US
Practice Address - Phone:608-690-8256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician