Healthcare Provider Details

I. General information

NPI: 1366706491
Provider Name (Legal Business Name): ANNE KATHRYN DEGREVE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE K. DEGREVE D.O

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7818 BIG SKY DR STE 105
MADISON WI
53719-2840
US

IV. Provider business mailing address

202 S PARK ST
MADISON WI
53715-1507
US

V. Phone/Fax

Practice location:
  • Phone: 608-203-5027
  • Fax: 608-571-3150
Mailing address:
  • Phone: 608-417-5965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125062289
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number64480-21
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number64480-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: