Kendra Mickelson

NPI #1992158356 in Eureka, Illinois

Provider Information

NPI Number
1992158356
Entity Type
Individual
Name
Kendra Mickelson
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Jul 20, 2016
Last Updated
Jul 20, 2016

Practice Location

Address
700 N MAIN ST
City
Eureka
ZIP Code
61530-1085
Phone
(309) 467-9094

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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