Individual
ASHLEY A MIKKELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8905 W LINCOLN AVE STE 505, WEST ALLIS, WI 53227-2470
(414) 329-5647
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11530-33
WI
363LF0000X
Family Nurse Practitioner
11530-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100191442
—
WI
Enumeration date
11/11/2021
Last updated
01/26/2025
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