Healthcare Provider Details

I. General information

NPI: 1902615016
Provider Name (Legal Business Name): RENEE M UZOBUIHE APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 MAPLE GROVE DR
MADISON WI
53719-5013
US

IV. Provider business mailing address

7234 E VALLEY RIDGE DR
MADISON WI
53719-2354
US

V. Phone/Fax

Practice location:
  • Phone: 608-845-0439
  • Fax:
Mailing address:
  • Phone: 608-658-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1633033
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: