Healthcare Provider Details

I. General information

NPI: 1871416867
Provider Name (Legal Business Name): KYLEIGH NICOLE JAY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S RURAL ST
HARTFORD WI
53027-2119
US

IV. Provider business mailing address

402 W SUMNER ST
HARTFORD WI
53027-1400
US

V. Phone/Fax

Practice location:
  • Phone: 262-673-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: