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Individual

DEBORAH ELAINE MICKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2828 CHICAGO AVE SOUTH, SUITE 300, MINNEAPOLIS, MN 55407
(612) 859-1656
Mailing address
2828 CHICAGO AVE SOUTH, SUITE 300, MINNEAPOLIS, MN 55407
(612) 859-1656

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R1697085
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
0661
MN

Other

Enumeration date
08/03/2012
Last updated
08/30/2018
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