Healthcare Provider Details

I. General information

NPI: 1083550669
Provider Name (Legal Business Name): RENEE LORRAINE REGER-KELSEY BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 RUSKIN ST
MADISON WI
53704-3469
US

IV. Provider business mailing address

730 EAGLE CREST DR
MADISON WI
53704-6425
US

V. Phone/Fax

Practice location:
  • Phone: 608-204-2100
  • Fax: 608-467-0573
Mailing address:
  • Phone: 608-347-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number170297-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: