Individual
MACIE MIKKELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3883 74TH AVE NE, FORT TOTTEN, ND 58335-6102
(701) 766-1600
Mailing address
3883 74TH AVE NE, FORT TOTTEN, ND 58335-6102
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R46047
ND
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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