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Individual

MS. GEORGIA R. DITZENBERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP-BC, PHD

Contact information

Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6236
(608) 417-6377
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(608) 829-5485

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
093006205N9 NNP-PP
OR
363LN0000X
Neonatal Nurse Practitioner
Primary
3563-033
WI

Other

Enumeration date
02/08/2007
Last updated
12/14/2015
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