Healthcare Provider Details

I. General information

NPI: 1649182031
Provider Name (Legal Business Name): MIKAYLA NOWINSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 ALDERSON ST
SCHOFIELD WI
54476-3910
US

IV. Provider business mailing address

6500 ALDERSON ST
SCHOFIELD WI
54476-3910
US

V. Phone/Fax

Practice location:
  • Phone: 715-359-6561
  • Fax: 715-241-0651
Mailing address:
  • Phone: 715-359-6561
  • Fax: 715-241-0651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number246957
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: