Provider Demographics
NPI:1447684261
Name:VISAUER, KAYLIN (APNP)
Entity type:Individual
Prefix:
First Name:KAYLIN
Middle Name:
Last Name:VISAUER
Suffix:
Gender:
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-5754
Mailing Address - Country:US
Mailing Address - Phone:262-532-3127
Mailing Address - Fax:
Practice Address - Street 1:2180 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-5754
Practice Address - Country:US
Practice Address - Phone:262-532-3127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5372363L00000X
WI5372-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100033289Medicaid
WIK400362066Medicare PIN