Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tyler Wendelborn

Individual provider Community Health Worker · NPI 1205763463

Tyler Wendelborn is a Community Health Worker in Jefferson, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2026.

Licensed in
WI
In the registry since
2026
Specialties on file
2

Practice location Address checks out

1541 Annex Rd
Jefferson, WI 53549-9803
Phone: (920) 674-5961
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X (WI)
Community Health Worker Taxonomy 172V00000X (WI)

Record details

NPI number1205763463
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 4, 2026
Last updated in NPPESMay 4, 2026
Certification dateMay 4, 2026
Mailing address1541 Annex Rd, Jefferson, WI 53549-9803

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