Provider Demographics
NPI:1174140115
Name:BEGLEY, KRISTA LYN (AUD)
Entity type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:LYN
Last Name:BEGLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 N TAYLOR DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3090
Mailing Address - Country:US
Mailing Address - Phone:920-323-0136
Mailing Address - Fax:
Practice Address - Street 1:1414 N TAYLOR DR STE 110
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3090
Practice Address - Country:US
Practice Address - Phone:920-323-0136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001770231H00000X
WI721-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist