Individual
MS. NISSA MIKKELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
NORTHERN ARIZONA VA HCS, 500 N. HWY 89, PRESCOTT, AZ 86313
(928) 445-4860
Mailing address
500 N. HWY 89, PRESCOTT, AZ 86313
(928) 445-4860
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5570
AZ
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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