Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grant Alexander Karlsson Ellifson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1659076719

Grant Alexander Karlsson Ellifson is a Student in an Organized Health Care Education/Training Program in Milwaukee, Wisconsin. Works from 2 locations. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

1801 W Wisconsin Ave
Milwaukee, WI 53233-2186
Phone: (608) 422-0516
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3434 E Washington Ave, Madison, WI 53704-4155 — (608) 443-5482

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 6001202 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1659076719
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 30, 2023
Last updated in NPPESJune 21, 2024
Certification dateJune 21, 2024

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