Provider Demographics
NPI:1548948979
Name:GRAFF, KAYLA TERESA (NP)
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:TERESA
Last Name:GRAFF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:KAYLA
Other - Middle Name:TERESA
Other - Last Name:SALLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-0812
Mailing Address - Fax:414-805-0855
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-0812
Practice Address - Fax:414-805-0855
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1416633363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1548948979Medicaid