Healthcare Provider Details

I. General information

NPI: 1285548826
Provider Name (Legal Business Name): KEVIN ROBERT LYNCH NRAEMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N 1ST ST
BONDUEL WI
54107-9212
US

IV. Provider business mailing address

PO BOX 744
BONDUEL WI
54107-0744
US

V. Phone/Fax

Practice location:
  • Phone: 715-304-7170
  • Fax:
Mailing address:
  • Phone: 715-304-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number70105837
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: