Provider Demographics
NPI:1386375814
Name:MUKAILA, SIKIRA
Entity type:Individual
Prefix:
First Name:SIKIRA
Middle Name:
Last Name:MUKAILA
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 1:2621 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-3880
Mailing Address - Country:US
Mailing Address - Phone:574-267-7169
Mailing Address - Fax:574-269-4189
Practice Address - Street 1:201 E RUDISILL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46806-1756
Practice Address - Country:US
Practice Address - Phone:888-470-0082
Practice Address - Fax:260-387-7181
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2025-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028297363LP0808X
OHAPRN.CNP.0034712363LP0808X
MDR216351363LP0808X
IN71016208A363LP0808X
VA0024184392363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health