Healthcare Provider Details

I. General information

NPI: 1740189323
Provider Name (Legal Business Name): KAYLEIGH MARIE VINGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLEIGH HUCK

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 10/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 MARKET ST LEONARD J. FISHER FAMILY, BUILDING - BUILDING A
BOARDMAN OH
44512-3457
US

IV. Provider business mailing address

1415 WINDEL WAY
YOUNGSTOWN OH
44512-3757
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-3276
  • Fax:
Mailing address:
  • Phone: 330-506-3717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0043823
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: