Healthcare Provider Details

I. General information

NPI: 1912801903
Provider Name (Legal Business Name): KAYLYN VINKAVICH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 MERTON AVE
HARTLAND WI
53029-1234
US

IV. Provider business mailing address

812 MERTON AVE
HARTLAND WI
53029-1234
US

V. Phone/Fax

Practice location:
  • Phone: 262-424-7141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number23572230
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: