Healthcare Provider Details

I. General information

NPI: 1497680524
Provider Name (Legal Business Name): BAILEY M UPMANN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 COMPASSION WAY
DODGEVILLE WI
53533-1956
US

IV. Provider business mailing address

800 COMPASSION WAY
DODGEVILLE WI
53533-1956
US

V. Phone/Fax

Practice location:
  • Phone: 608-930-8000
  • Fax:
Mailing address:
  • Phone: 608-930-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9046-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: