JESSICA MICKELSEN (NPI# 1275157554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275157554 |
| Entity Type | Individual |
| Full Name | JESSICA MICKELSEN |
| Credential | BS, CNIM, LMT |
| Practice Address |
13440 Parker Commons Blvd Ste 103 Fort Myers FL 33912-1816 |
| Mailing Address |
9720 Gladiolus Preserve Cir Fort Myers FL 33908-9720 |
| Practice Telephone | 2396710695 |
| Mailing Telephone | 2396710695 |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA92171 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508347378 | Jessica Mickelsen | Physician Assistant | 910 W 5th Ave Ste 501, Spokane, WA 99204-2967 | 2018-08-28 |
| Street Address |
13440 PARKER COMMONS BLVD STE 103 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33912-1816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134684814 | Performance Health Surgery Center | Clinic/Center | 9500 Gulf Research Lane, Fort Myers, FL 33912 | 2019-02-06 |
| 1609351899 | Voa Lee County Health Care Facility, Inc. | Skilled Nursing Facility | 14750 Hope Center Loop, Ft. Myers, FL 33912 | 2018-10-03 |
| 1245719954 | Lauren Grimes | Pharmacist | 13711 S Tamiami Trail, Fort Myers, FL 33912 | 2018-08-13 |
| 1972080828 | Solaris Rehab, LLC | Clinic/Center | 14001 Metro Parkway, Fort Myers, FL 33912 | 2018-07-24 |
| 1467943803 | Marie Veronica Scott | Nurse Practitioner | 14015 Danpak Loop, Fort Myers, FL 33912 | 2018-05-22 |
| 1952892291 | Daniels Modern Dentistry, Pa | Dentist | 6871 Daniels Parkway, Suite 100, Fort Myers, FL 33912 | 2018-05-22 |
| 1295258994 | Julie Ann Jakobi | Counselor | 18 Quanery Court, Fort Myers, FL 33912 | 2017-07-25 |
| 1205359908 | Maria Reyes | Developmental Therapist | 8961 Daniels Center Drive Suite 401, Fort Myers, FL 33912 | 2017-07-25 |
| 1669919288 | Darinka Ruiz | Social Worker | 961 Daniels Center Drive, Suite 401, Fort Myers, FL 33912 | 2017-01-20 |
| 1730622598 | Valerie Starnes | Nurse Practitioner | 13411 Parker Commons Blvd Ste 101, Fort Myers, FL 33912 | 2016-11-28 |
| Find all providers in zip 33912 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471053 | Cassandra Biscardi | Massage Therapist | 9634 Roundstone Cir, Fort Myers, FL 33967-5155 | 2020-09-11 |
| 1316551344 | Jamie Lynne Gilbert | Massage Therapist | 1754 Maple Ave, Fort Myers, FL 33901-6015 | 2020-09-08 |
| 1053925495 | Renata Bailey | Massage Therapist | 5351 Chippendale Cir E, Fort Myers, FL 33919-2237 | 2020-09-02 |
| 1629682398 | Shannon Zimmerman | Massage Therapist | 11550 Villa Grand Apt 1311, Fort Myers, FL 33913-8613 | 2020-09-01 |
| 1497364525 | Jessica Bibeau | Massage Therapist | 16521 San Carlos Blvd Ste 200, Fort Myers, FL 33908-5245 | 2020-07-24 |
| 1265082622 | Brenda Schulpius | Massage Therapist | 4460 Fowler St Ste 4, Fort Myers, FL 33901-2617 | 2019-09-18 |
| 1922501089 | Luis Alvarez | Massage Therapist | 2665 Cleveland Ave Ste 201-205, Fort Myers, FL 33901-5850 | 2018-03-15 |
| 1093228512 | Tanya Ashley Solt | Massage Therapist | 2319 Davis Blvd, Fort Myers, FL 33905-4846 | 2017-11-06 |
| 1114306792 | Patricia Ortiz | Massage Therapist | 13120 Westlinks Ter, Unit 9, Fort Myers, FL 33913-8652 | 2015-05-28 |
| 1275963670 | Tifani Megan Revels Lee | Massage Therapist | 6202 Presidential Ct, Suite B, Fort Myers, FL 33919-3563 | 2013-11-21 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33912 |
Please comment or provide details below to improve the information on JESSICA MICKELSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.