Healthcare Provider Details

I. General information

NPI: 1053887943
Provider Name (Legal Business Name): DENITA K WARD APNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2018
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 JOHN Q HAMMONS DR STE 400
MADISON WI
53717-1967
US

IV. Provider business mailing address

1200 JOHN Q HAMMONS DR STE 400
MADISON WI
53717-1967
US

V. Phone/Fax

Practice location:
  • Phone: 608-410-2700
  • Fax: 608-410-2905
Mailing address:
  • Phone: 608-410-2700
  • Fax: 608-410-2905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8365-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017008379
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: