Individual
MR. JEFFREY WAYNE MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13208 S 21ST ST, BELLEVUE, NE 68123-2083
(402) 516-6553
Mailing address
13208 S 21ST ST, BELLEVUE, NE 68123-2083
(402) 516-6553
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
NE
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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