Individual provider · Type 1 NPI

Mikayla L. Bogulski

Physician Assistant · Johnson City, TN

NPI number 1013552439 Active

Practice location

2410 Susannah St
Johnson City, TN 37601-1748

Fax (423) 282-0035

Specialties and licenses

Taxonomy	Code	License
Physician Assistant Primary	363A00000X	None listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1013552439

Mikayla L. Bogulski's National Provider Identifier is 1013552439, issued on Nov 8, 2019. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Johnson City, TN. The record was last updated on Jun 15, 2026.