Individual
PENNY K DERRINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6161
Mailing address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
702-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3059
DEAN HEALTH INSURANCE
WI
05
—
42936800
—
WI
Enumeration date
05/04/2006
Last updated
07/11/2013
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