Kallianne Nicole Mikesch is a Physician Assistant practicing in Green Bay, Wisconsin. The National Provider Identifier (NPI) is #1902690639, which was assigned on April 7, 2025, and the registration record was last updated on August 8, 2025. The practitioner's main practice location is at 2845 Greenbrier Rd, Green Bay, WI 54311-6519; the contact telephone number is 9204909046. The primary taxonomy of Kallianne Nicole Mikesch is Physician Assistant (363A00000X). Kallianne Nicole Mikesch is licensed to practice in the state of Wisconsin (#8390-23).
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, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
| NPI | 1902690639 |
| Entity Type | Individual |
| Provider Name | KALLIANNE NICOLE MIKESCH |
| Gender | Female |
| Credential | PA-C |
| Practice Address |
2845 Greenbrier Rd Green Bay WI 54311-6519 |
| Practice Telephone | 9204909046 |
| Mailing Address |
1035 Kepler Dr Green Bay WI 54311-8320 |
| Mailing Telephone | 9204909046 |
| Certification Date | 2025-08-08 |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-08-08 |
| Is Sole Proprietor | N |
| PAC ID |
5597270728 Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID |
| Full Name | KALLIANNE NICOLE MIKESCH |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Address |
Po Box Suite 735044 Chicago IL 60673-5044 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 8390-23 | WI |
| Other Identifier | Issuing State | Issuer | Identifier Type |
|---|---|---|---|
| 100333414 | WI | MEDICAID |
| Code | 363A00000X |
| Taxonomy | Physician Assistant |
| Classification | Physician Assistant |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Definition: 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, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Claudia Mauldin | 485 Tom Hall St Ste 101, Fort Mill, SC 29715-2353 | Physician Assistant | 2025-11-08 |
| Amanda Glasenapp | 1010 Stillwell Dr Unit 2204, Durham, NC 27707-6274 | Physician Assistant | 2025-11-08 |
| Maxwell Aaron Jakubowicz | 18 Cobra Cir, Fort Bragg, NC 28307-6153 | Physician Assistant | 2025-11-07 |
| Ifeanyi Victor Osunwoke | 33000 Palmer Rd, Westland, MI 48186-5517 | Physician Assistant | 2025-11-07 |
| Hanna-Rose Isabella Hix · Hanna-Rose Lacy | 101 Medical Pkwy Ste 220, Lakeway, TX 78738-5649 | Physician Assistant | 2025-11-07 |
| Hailey Michel Camper | 4503 Nightfall Ct, Durham, NC 27713-6538 | Physician Assistant | 2025-11-08 |
| Mikalee Joy Kerr | 3970 Perkiomen Ave, Reading, PA 19606-2757 | Physician Assistant | 2025-11-07 |
| Abbygayle Nicole Parshall | 4001 W Mcnichols Rd, Detroit, MI 48221-3038 | Physician Assistant | 2025-11-07 |
| Bridget Carey | 84 Granite Ave Apt 3, Dorchester, MA 02124-5216 | Physician Assistant | 2025-11-07 |
| Whitley Porter | 13001 E 17th Pl, Aurora, CO 80045-2570 | Physician Assistant | 2025-11-07 |
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| Street Address |
2845 GREENBRIER RD |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54311-6519 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Kaylee Marie Luck | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Urology Physician | 2020-03-26 |
| Brianne Conklin | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Family Nurse Practitioner | 2021-11-02 |
| Sarah Zeeshan | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Family Medicine Physician | 2021-03-31 |
| Alyssa Rose Doherty | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Nurse Practitioner | 2025-03-08 |
| Constance Panton | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Obstetrics & Gynecology Physician | 2021-04-01 |
| Clarice Elizabeth Danen | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Genetic Counselor (M.S.) | 2025-09-17 |
| Jonathan Scheel | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Critical Care Medicine (Internal Medicine) Physician | 2020-03-25 |
| Nicholas Gibson | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Internal Medicine Physician | 2022-04-05 |
| Amanda Lynn Rucinski | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Gerontology Nurse Practitioner | 2025-07-28 |
| Alishia Parma | 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | Family Nurse Practitioner | 2014-06-30 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Helga Aquino Meyer · Helga Aquino Perpetuo | 3150 Gershwin Dr, Green Bay, WI 54311-4328 | Clinical Social Worker | 2023-08-16 |
| Jennifer M Wachowiak | 1496 Bellevue St Ste 502, Green Bay, WI 54311-4251 | Psychiatric/Mental Health Nurse Practitioner | 2025-08-25 |
| Kelsey Rose Esser · Kelsey Janssen | 2605 Development Dr, Green Bay, WI 54311-4240 | Physician Assistant | 2024-05-30 |
| Kathryn Meadowcroft | 2581 Development Dr, Green Bay, WI 54311-4247 | Family Nurse Practitioner | 2023-01-06 |
| Lori Ann Keisic Hummel · Lori Ann Keisic Grillo | 1160 Kepler Dr, Green Bay, WI 54311 | Physical Therapist | 2012-04-23 |
| Sbh-Green Bay LLC | 1351 Ontario Rd, Green Bay, WI 54311 | Mental Health Clinic/Center (Including Community Mental Health Center) | 2016-09-21 |
| Jennifer Ann Russell | 2851 University Ave, Green Bay, WI 54311 | Student in an Organized Health Care Education/Training Program | 2017-09-27 |
| Golden Counseling, LLC | 2563 Development Dr, Green Bay, WI 54311-4246 | Community/Behavioral Health Agency | 2025-06-19 |
| Semyon Zarkhin | 2617 Development Dr, Green Bay, WI 54311-4240 | Dermatology Physician | 2007-07-23 |
| Brittany Shoemaker | 2633 Development Dr Ste 40, Green Bay, WI 54311-4239 | Dental Hygienist | 2025-09-29 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Nicole Elizabeth Bower · Nicole Evans | 2050 Kenny Rd Fl 4, Columbus, OH 43221-3502 | Family Nurse Practitioner | 2024-04-16 |
| Nicole J Mcdowell-Horn · Nicole June Stanford | 412 S Avenue F Apt 304, Texico, NM 88135-9663 | Mental Health Counselor | 2018-01-23 |
| Nicole France · Nicole Moody Weber | 945 Concord St, Framingham, MA 01701-4613 | Behavior Technician | 2025-05-20 |
| Leanne Nicole Franklin · Leann Nicole Garrels | 2111 Sw 20th Pl, Ocala, FL 34471-7734 | Family Nurse Practitioner | 2025-07-25 |
| Nicole Anissa Kujawa · Nicole A Claus Pino | 17100 W North Ave, Suite 200, Brookfield, WI 53005 | Physician Assistant | 2006-09-13 |
| Nicole Margaret Ashkar · Nicole Villegas | 5121 Kingdom Way Ste 100, Raleigh, NC 27607-6063 | Behavioral Analyst | 2018-03-07 |
| Nicole Mancuso · Nicole Mariella Todd | 126 Timber Trl, Greentown, PA 18426-2549 | Community/Behavioral Health Agency | 2020-03-04 |
| Nicole Kratochvil · Nicole Catherine Keiser | 812 N 22nd St, Blair, NE 68008-1128 | Medical Physician Assistant | 2011-07-19 |
| Nicole Monique Vance · Nicole Kostera | 511 Greenwood Ave, Lehigh Acres, FL 33972-4025 | Critical Care Medicine Registered Nurse | 2024-04-18 |
| Nicole Elizabeth Mcquade · Nicole Faber | 830 Harrison Avenue, 3rd Fl, Moakley Bldg, Hematology/Oncology, Boston, MA 02118-2905 | Physician Assistant | 2022-09-13 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |