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Individual

MRS. VICKI LYNN MICKELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7237
(651) 982-7236
Mailing address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7237
(651) 982-7236

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R073057-4
MN

Other

Enumeration date
11/10/2010
Last updated
11/10/2010
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