Individual
MIKAYLA ELLEN SIEMSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
12025 276TH AVE NW, ZIMMERMAN, MN 55398-8923
(763) 350-6676
Mailing address
200 ELM ST N, ONAMIA, MN 56359-7901
(320) 532-3154
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
11970
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11970
LICENSE
MN
Enumeration date
08/15/2024
Last updated
05/12/2025
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