Individual
JOSEPH F MIKOLIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
75 MACKUBIN ST, SAINT PAUL, MN 55102-2021
(651) 222-4265
Mailing address
75 MACKUBIN ST, SAINT PAUL, MN 55102-2021
(651) 222-4265
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 133937-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5600 89 800
—
MN
Enumeration date
04/05/2006
Last updated
08/31/2012
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