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General NPI Number Information
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NPI Number | 1598196974
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Entity Type | Individual
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Provider Name | DENYSE SIHAM NIZAM PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 5429 PENNY LN
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City | MADISON
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State | WI
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Zip | 53718-4418
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Country | US
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Telephone | 720-226-4710
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Fax |
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Provider Business Mailing Address
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Address Line | 5429 PENNY LN
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City | MADISON
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State | WI
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Zip | 53718-4418
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 100961-875
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5596
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0003941
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 5596
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License Number State | AZ
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