Kaylee K Bovard
Individual provider Active NPI Licensed Practical Nurse · Superior, WI
NPI 1487441002 · NPPES record last updated Aug 4, 2026
Key facts
- NPI
- 1487441002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 821761 (MN)
- Practice address
- 718 22ND Ave E
Superior, WI 54880-3728 - Phone
- (580) 491-0606
- NPI assigned
- Apr 24, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 821761 | MN | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 821761 | MN | Yes |
Addresses
Primary practice location
718 22ND Ave E
Superior, WI 54880-3728
Mailing address
718 22ND Ave E
Superior, WI 54880-3728
Phone (580) 491-0606
Other providers in Superior, WI
- Sylvia Margaret Bevis
- Bio-Medical Applications of Wisconsin, Inc.
- Paula Bjoralt
- Alisha Marie Bliss
- Mandy Kay-Marie Boese
- Katherine Frances Bradley
- Vicki Brady
- Jason C. Bramstedt
- Gwendolyn Marie Brand
- Heather Branham
All providers in Superior, WI · Licensed Practical Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.