Provider Demographics
NPI:1376755686
Name:MIKALAUSKAS, ELENA (MS, RN, CNS)
Entity Type:Individual
Prefix:MISS
First Name:ELENA
Middle Name:
Last Name:MIKALAUSKAS
Suffix:
Gender:F
Credentials:MS, RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4929 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440-2119
Mailing Address - Country:US
Mailing Address - Phone:937-434-8367
Mailing Address - Fax:
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-6317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH212192163W00000X, 163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WX0200XNursing Service ProvidersRegistered NurseOncology