Provider Demographics
NPI:1215674338
Name:BISINGER, KAYLA A (MM, LAT, ATC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:A
Last Name:BISINGER
Suffix:
Gender:F
Credentials:MM, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 72ND ST
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:IA
Mailing Address - Zip Code:52309-8521
Mailing Address - Country:US
Mailing Address - Phone:319-480-2087
Mailing Address - Fax:
Practice Address - Street 1:1513 72ND ST
Practice Address - Street 2:
Practice Address - City:MONMOUTH
Practice Address - State:IA
Practice Address - Zip Code:52309-8521
Practice Address - Country:US
Practice Address - Phone:319-480-2087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0975712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer