Mickelson, Matthew Allan

Mickelson, Matthew Allan is an individual health care provider with primary practice located at 4200 Savannah Dr , Deforest WI 53532-2909. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Mickelson, Matthew Allan can be contacted via phone (608) 417-3300.

Contact Information

Primary practice address
4200 Savannah Dr Deforest WI 53532-2909
Phone: (608) 417-3300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 241314 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 13661-33 Wisconsin

Profile Details

NPI number 1942907647
LBN Legal business name Mickelson, Matthew Allan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2023
Last updated Sep 12th, 2023 - about 3 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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