Provider Demographics
NPI:1013788397
Name:TERESINSKI, KYLA P (APNP)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:P
Last Name:TERESINSKI
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:KYLA
Other - Middle Name:P
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:510 N 17TH AVE STE C
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4281
Practice Address - Country:US
Practice Address - Phone:715-849-5333
Practice Address - Fax:715-849-4083
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14917-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner