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NPI Code Detail

MEDICARE: KAYLA NIEHAUS

MEDICARE:   KAYLA  NIEHAUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363AS0400XSurgical Physician Assistant8863-23WI

General Provider Information

NPI Number : 1083462923
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA NIEHAUS
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53792-0001
Country : US
Telephone Number : 608-263-6190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2024
Last Update Date : 04/06/2026

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Directions to “ KAYLA NIEHAUS ” Practice Location

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