Kendra Mickelson

Skilled Nursing Facility · Eureka, IL

Individual Active NPI

NPI number 1992158356

Practice location

700 N Main St
Eureka, IL 61530-1085
Phone
(309) 467-9094
Fax
(309) 467-9011

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NPI record

NPI
1992158356
Entity type
Individual (Type 1)
Enumeration date
July 20, 2016
Last updated
July 20, 2016
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X 0042424 IL
Skilled Nursing Facility 314000000X 1694647 IL

About Kendra Mickelson

Kendra Mickelson is a healthcare provider registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 700 N Main St, Eureka, IL 61530-1085. The NPI number 1992158356 was assigned on July 20, 2016 and the record was last updated on July 20, 2016.

Kendra Mickelson lists 2 licenses in the registry: #0042424 (IL) for Skilled Nursing Facility; #1694647 (IL) for Skilled Nursing Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kendra Mickelson?

The NPI number is 1992158356.

What is the phone number of Kendra Mickelson?

The phone number listed for the practice location is (309) 467-9094.

Where is Kendra Mickelson located?

700 N Main St, Eureka, IL 61530-1085.

What is the taxonomy code for Kendra Mickelson?

The primary taxonomy code is 314000000X – Skilled Nursing Facility; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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