Basic Information
| Provider Information | |||||||||
| NPI: | 1306078688 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MIKOLAJEWSKI | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MS, RN, CPNP-AC/PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 CHILDRENS PLZ | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454041873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9376415842 | ||||||||
| FaxNumber: | 9376413000 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 CHILDRENS PLZ | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454041898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9376413000 | ||||||||
| FaxNumber: | 9376414617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2009 | ||||||||
| LastUpdateDate: | 06/10/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | COA10847-NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.