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NPI Code Detail

MEDICARE: KERI MALLON

MEDICARE:   KERI  MALLON
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
1235Z00000XSpeech-Language Pathologist1590012158WI

General Provider Information

NPI Number : 1265382139
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERI MALLON
Provider Business Mailing Address
First Line : N172W20140 WOODLAND TRL
Second Line :
City : JACKSON
State : WI
Zip : 53037-9388
Country : US
Telephone Number : 262-352-3688
Fax Number :
Provider Business Practice Location Address
First Line : 3555 N CALHOUN RD
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-1700
Country : US
Telephone Number : 262-781-3030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2026
Last Update Date : 01/30/2026

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Directions to “ KERI MALLON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.