Individual
KELLEY MIKKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-2540
Mailing address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-2540
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6542
MN
Other
Enumeration date
06/28/2019
Last updated
10/28/2024
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