Individual
KENDRA K DEJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8218-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386970119
—
WI
Enumeration date
10/29/2009
Last updated
11/06/2020
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