Healthcare Provider Details

I. General information

NPI: 1821903972
Provider Name (Legal Business Name): KILEY OURADNIK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 CALUMET AVE
MANITOWOC WI
54220-5546
US

IV. Provider business mailing address

1721 SAEMANN AVE
SHEBOYGAN WI
53081-2342
US

V. Phone/Fax

Practice location:
  • Phone: 920-686-2333
  • Fax: 920-686-0352
Mailing address:
  • Phone: 920-783-6633
  • Fax: 920-783-6392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number185371-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: