Healthcare Provider Details

I. General information

NPI: 1376755686
Provider Name (Legal Business Name): ELENA MIKALAUSKAS MS, RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST
DAYTON OH
45409-2722
US

IV. Provider business mailing address

4929 ARROWHEAD DR
KETTERING OH
45440-2119
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-6317
  • Fax:
Mailing address:
  • Phone: 937-434-8367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number212192
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number212192
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: