Healthcare Provider Details

I. General information

NPI: 1497685135
Provider Name (Legal Business Name): PAIGE KERMENDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 ILLINOIS AVE
STEVENS POINT WI
54481-3114
US

IV. Provider business mailing address

850 COMMONS CIR APT 2
PLOVER WI
54467-4227
US

V. Phone/Fax

Practice location:
  • Phone: 715-346-5000
  • Fax:
Mailing address:
  • Phone: 414-499-7445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7362154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: