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Individual

JENNIFER A MICKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
901 STERTHAUS DR, ORMOND BEACH, FL 32174-5133
(740) 507-3759
Mailing address
15116 CHAPEL RD, DANVILLE, OH 43014-9661
(740) 507-3759

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
025365
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.11019960
FL

Other

Enumeration date
02/01/2020
Last updated
07/21/2022
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