Dehaven, Kiley

Dehaven, Kiley is an individual health care provider with primary practice located at 2365 Deming Way , Middleton WI 53562-5512. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Dehaven, Kiley can be contacted via phone (608) 824-6160.

Contact Information

Primary practice address
2365 Deming Way Middleton WI 53562-5512
Phone: (608) 824-6160
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 4756 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1063071157
LBN Legal business name Dehaven, Kiley
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2019
Last updated Feb 8th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063071157 NPPES
Wisconsin MEDICAID 1063071157

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