Provider Demographics
NPI:1609768076
Name:CANN, MIKAYLA (DNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:
Last Name:CANN
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W6428 SONNY DR APT 222
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952-0047
Mailing Address - Country:US
Mailing Address - Phone:608-213-2014
Mailing Address - Fax:
Practice Address - Street 1:THEDACARE REGIONAL MEDICAL CENTER-APPLETON
Practice Address - Street 2:1818 N MEADE STREET
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-454-2169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17114-33207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine