Individual
JOHN MICHAEL MIKKELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 S COLUMBIA RD - ALTRU HOSPITAL, GRAND FORKS, ND 58201
(701) 780-6000
(701) 364-8078
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
(701) 364-8078
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R36883
ND
Other
Enumeration date
01/24/2014
Last updated
02/26/2019
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