Provider Demographics
NPI:1053887943
Name:WARD, DENITA K (APNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:DENITA
Middle Name:K
Last Name:WARD
Suffix:
Gender:F
Credentials:APNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 JOHN Q HAMMONS DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1967
Mailing Address - Country:US
Mailing Address - Phone:608-410-2700
Mailing Address - Fax:608-410-2905
Practice Address - Street 1:1200 JOHN Q HAMMONS DR STE 400
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1967
Practice Address - Country:US
Practice Address - Phone:608-410-2700
Practice Address - Fax:608-410-2905
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2017008379363LF0000X
WI8365-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1053887943Medicaid