Provider Demographics
NPI:1811949639
Name:KILWAY, DENISE M (APNP)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:M
Last Name:KILWAY
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC GASTROENTEROLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-3690
Mailing Address - Fax:414-266-3676
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC GASTROENTEROLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-3690
Practice Address - Fax:414-266-3676
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1165363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1811949639Medicaid
004806261ROtherHUMANA
WI1811949639Medicaid
WI035P73601Medicare PIN
004806261ROtherHUMANA