Theisen, Micaela T
Theisen, Micaela T is an individual health care provider with primary practice located at Hwy 191 And Hospital Drive , Chinle AZ 86503. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Theisen, Micaela T can be contacted via phone (928) 674-7090.Contact Information
Primary practice address
Hwy 191 And Hospital Drive
Chinle AZ 86503
Phone: (928) 674-7090
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | AP60577678 | Washington |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | NP-1523A | Idaho |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP60577678 | Washington |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP60577678 | Washington |
Profile Details
NPI number | 1902158421 |
---|---|
LBN Legal business name | Theisen, Micaela T |
Credentials | DNP, FNP-BC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 8th, 2012 |
Last updated | May 16th, 2024 - about 4 months 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1902158421 | NPPES |
Washington | MEDICAID | 2047222 |
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