Mickelson, Julie

Mickelson, Julie is an individual health care provider with primary practice located at 2311 N Prospect Ave , Milwaukee WI 53211-4445. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Mickelson, Julie can be contacted via phone (414) 319-3000.

Contact Information

Primary practice address
2311 N Prospect Ave Milwaukee WI 53211-4445
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 37828 Wisconsin

Profile Details

NPI number 1356347744
LBN Legal business name Mickelson, Julie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Jun 12th, 2012 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1356347744 NPPES
Wisconsin Other 5095123 AETNA
Wisconsin MEDICAID 32234000 AETNA

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