Mickelsen, Tracy D.

Mickelsen, Tracy D. is an sole proprietor health care provider with primary practice located at 3015 E Magic View Dr , Meridian ID 83642-3743. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Mickelsen, Tracy D. can be contacted via phone (208) 855-2410.

Contact Information

Primary practice address
3015 E Magic View Dr Meridian ID 83642-3743
Fax: (208) 482-5515
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 178692 Idaho

Profile Details

NPI number 1801073655
LBN Legal business name Mickelsen, Tracy D.
Credentials CSFA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2008
Last updated Dec 7th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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