Individual
KORTNEY L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2402 WINNEBAGO ST, MADISON, WI 53704-5341
(608) 828-7603
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(608) 252-8268
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4360-23
WI
363AM0700X
Medical Physician Assistant
Primary
4360-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154844488
—
WI
Enumeration date
07/19/2017
Last updated
07/10/2024
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