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General NPI Number Information
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NPI Number | 1265748503
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Entity Type | Individual
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Provider Name | KAYLA ANN STANKOWSKI JOHNSON LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 5401 W INTEGRITY WAY
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City | APPLETON
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State | WI
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Zip | 54913-8602
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Country | US
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Telephone | 844-274-6849
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Fax |
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Provider Business Mailing Address
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Address Line | 5526 W MICHAELS DR APT 1
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City | APPLETON
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State | WI
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Zip | 54913-8644
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Country | US
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Telephone | 715-240-8544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1348-39
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License Number State | WI
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