Provider Demographics
NPI:1497397293
Name:HYLAND, MIKAYLA BROOKE
Entity Type:Individual
Prefix:MRS
First Name:MIKAYLA
Middle Name:BROOKE
Last Name:HYLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32087 ELECTRIC BLVD
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-1852
Mailing Address - Country:US
Mailing Address - Phone:440-961-0957
Mailing Address - Fax:
Practice Address - Street 1:32087 ELECTRIC BLVD
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-1852
Practice Address - Country:US
Practice Address - Phone:440-961-0957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-13
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other