Mikkelson-Heredia, Carrie Denise

Mikkelson-Heredia, Carrie Denise is an sole proprietor health care provider with primary practice located at 450 N Roxbury Dr Suite 600, Beverly Hills CA 90210-4232. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Mikkelson-Heredia, Carrie Denise can be contacted via phone (310) 651-2280.

Contact Information

Primary practice address
450 N Roxbury Dr Suite 600 Beverly Hills CA 90210-4232
Phone: (310) 651-2280
Fax: (310) 651-2260
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 3288 California

Profile Details

NPI number 1649345760
LBN Legal business name Mikkelson-Heredia, Carrie Denise
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 22nd, 2006
Last updated Jul 16th, 2015 - about 10 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 1649345760 NPPES
California Other 508419 STATE LICENSE NURSE
California Other 074093 STATE LICENSE NURSE
California Other 3288 STATE LICENSE NURSE

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