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Individual

SCOTT D MINGILINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC, PMHNP-BC

Contact information

Practice address
5910 77TH ST STE A, KENOSHA, WI 53142-4104
(262) 649-5303
(262) 315-1700
Mailing address
5910 77TH ST STE A, KENOSHA, WI 53142-4104
(262) 649-5303
(262) 315-1700

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
7989-33
WI
363LF0000X
Family Nurse Practitioner
7989-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7989-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100074157
WI
Enumeration date
01/08/2018
Last updated
10/29/2025
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