JENNIFER MIKKELSEN (NPI# 1487184487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487184487 |
| Entity Type | Individual |
| Full Name | JENNIFER MIKKELSEN |
| Other Name | JENNIFER STUBER |
| Credential | RDMS, RVT, RT(R) |
| Practice Address |
1700 E Bogard Rd Ste A200 Wasilla AK 99654-6569 |
| Practice Telephone | (907) 357-2158 |
| Mailing Telephone | 9073572158 |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2017-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471S1302X |
Radiologic Technologist Specialization: Sonography |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1700 E BOGARD RD STE A200 |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-6569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255824801 | Real Time Inc | Radiologic Technologist | 1700 E Bogard Rd Ste A200, Wasilla, AK 99654 | 2018-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 2471S1302X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Sonography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255824801 | Real Time Inc | Radiologic Technologist | 1700 E Bogard Rd Ste A200, Wasilla, AK 99654 | 2018-06-08 |
| 1023548021 | Christi Mae Goff | Radiologic Technologist | 1700 E Bogard Rd Ste 200, Wasilla, AK 99654-6563 | 2017-06-13 |
| 1346555844 | Real Time II LLC | Radiologic Technologist | 1700 E Bogard Rd # 101, Wasilla, AK 99654-6563 | 2010-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992995260 | Gene George Brown | Radiologic Technologist | 35555 Spur Hwy, #163, Soldotna, AK 99669-7625 | 2007-08-01 |
| 1134326457 | Deanna G Burrows | Radiologic Technologist | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2007-06-29 |
Please comment or provide details below to improve the information on JENNIFER MIKKELSEN.
| 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.