Provider Demographics
NPI:1265748503
Name:JOHNSON, KAYLA ANN STANKOWSKI (LAT, ATC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN STANKOWSKI
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ANN
Other - Last Name:STANKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAT, ATC
Mailing Address - Street 1:5526 W MICHAELS DR APT 1
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8644
Mailing Address - Country:US
Mailing Address - Phone:715-240-8544
Mailing Address - Fax:
Practice Address - Street 1:5401 W INTEGRITY WAY
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8602
Practice Address - Country:US
Practice Address - Phone:844-274-6849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2025-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2255A2300X
WI1348-392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer