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General NPI Number Information
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NPI Number | 1396568762
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Entity Type | Individual
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Provider Name | ALLISON KAY FENDRICK FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1705 HOFFMAN ST
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City | MADISON
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State | WI
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Zip | 53704-2510
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Country | US
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Telephone | 608-828-4853
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 SUMMIT AVE APT 10
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City | STOUGHTON
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State | WI
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Zip | 53589-2582
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Country | US
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Telephone | 608-225-1484
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 16146-33
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License Number State | WI
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