Provider Demographics
NPI:1447020870
Name:MICHIGAN, MIKHAYLA (APN)
Entity type:Individual
Prefix:DR
First Name:MIKHAYLA
Middle Name:
Last Name:MICHIGAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HIGH MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9461
Mailing Address - Country:US
Mailing Address - Phone:609-254-7754
Mailing Address - Fax:
Practice Address - Street 1:602 W CUTHBERT BLVD UNIT 26
Practice Address - Street 2:
Practice Address - City:HADDON TWP
Practice Address - State:NJ
Practice Address - Zip Code:08108-3642
Practice Address - Country:US
Practice Address - Phone:856-946-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14984100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily