Individual
MS. GENELL LYNN MIKKALSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
580 COURT ST, KEENE, NH 03431-1718
(603) 354-5454
Mailing address
234 ROXBURY RD, MARLBOROUGH, NH 03455-2216
(603) 876-9448
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
048845-23-01
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048845-21
REGISTERED NURSE
NH
01
—
048845-23-01
ARNP-CERTIFIED NURSE MIDW
NH
Enumeration date
10/26/2006
Last updated
07/08/2007
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