Healthcare Provider Details

I. General information

NPI: 1629029152
Provider Name (Legal Business Name): KATHRYN M DENSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W NATIONAL AVE VA MEDICAL CENTER
MILWAUKEE WI
53295-0001
US

IV. Provider business mailing address

5000 W NATIONAL AVE VA MEDICAL CENTER
MILWAUKEE WI
53295-0001
US

V. Phone/Fax

Practice location:
  • Phone: 414-384-2000
  • Fax: 414-382-5376
Mailing address:
  • Phone: 414-384-2000
  • Fax: 414-382-5376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number39032
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: