Healthcare Provider Details

I. General information

NPI: 1114079225
Provider Name (Legal Business Name): TORILYNNE KERSTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TORILYNNE WUESTENHAGEN

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3344 CONCORD AVE
MADISON WI
53714-1101
US

IV. Provider business mailing address

5221 NINEBARK DR
FITCHBURG WI
53711-7620
US

V. Phone/Fax

Practice location:
  • Phone: 608-204-2500
  • Fax:
Mailing address:
  • Phone: 608-279-1598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2760-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: