| NPI | 1003628447 |
|---|---|
| Other Name | JAKE PHILLIP MIHKELSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN10030124) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95381885) |
| 163W00000X Registered Nurse (Licence: MA RN10030124) | |
| Enumeration Date | 2025-01-23 |
| Last Update Date | 2025-10-26 |