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Individual

WILLIAM ROBERT MICKLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-8649
Mailing address
986 STOCKS ST, ATLANTIC BEACH, FL 32233-2560
(210) 589-0491

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9372941
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11022369
FL

Other

Enumeration date
11/21/2020
Last updated
11/06/2022
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