Healthcare Provider Details

I. General information

NPI: 1306049937
Provider Name (Legal Business Name): PATRICIA ANN MICHALS ARPN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

1206 DAKOTA AVE
DULUTH MN
55803-1834
US

V. Phone/Fax

Practice location:
  • Phone: 715-398-2951
  • Fax:
Mailing address:
  • Phone: 218-728-4371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR 069799-2
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: