Individual
KAYE C MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
347 SMITH AVE N, SUITE 203, SAINT PAUL, MN 55102-2387
(651) 241-7733
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
38554
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
840527100
—
MN
Enumeration date
04/07/2006
Last updated
12/05/2011
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