Individual provider · Type 1 NPI

Kallianne Nicole Mikesch, PA-C

Physician Assistant · Green Bay, WI

NPI number 1902690639 Active

Practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Call (920) 288-4060 Map

Fax (920) 288-4067

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X8390-23 (WI)

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 1902690639

Kallianne Nicole Mikesch, PA-C's National Provider Identifier is 1902690639, issued on Apr 7, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Green Bay, WI. The record was last updated on May 7, 2026.