MICHAEL SCOTT MICKELSEN

BOISE, ID
NPI1275838021
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  RNA-783)
Enumeration Date2011-01-25
Last Update Date2011-01-25
Business Address
-- MICHAEL SCOTT MICKELSEN CRNA
1055 N CURTIS RD
BOISE, ID 83706-1309
Phone number: 208-390-1648
Mailing Address
-- MICHAEL SCOTT MICKELSEN CRNA
413 N 4370 E
RIGBY, ID 83442-4929
Phone number: 208-390-1648
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