Individual
MIKAYLA LYNN BOETTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1305 W MAIN ST, WHITEWATER, WI 53190-1503
(262) 473-4548
(262) 472-7691
Mailing address
1305 W MAIN ST, WHITEWATER, WI 53190-1503
(262) 473-4548
(262) 472-7691
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13437
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013616473
—
WI
Enumeration date
02/24/2023
Last updated
03/02/2023
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