Individual
GIDEON KAZAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2488 DAHLE STREET, MADISON, WI 53704
(917) 346-4459
Mailing address
2488 DAHLE STREET, MADISON, WI 53704
(917) 346-4459
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
318240-31
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318240-31
—
WI
Enumeration date
12/15/2015
Last updated
12/15/2015
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