SHAYNA JO MICKELSEN NPI 1639024888

NPI Information

  • NPI: 1639024888
  • Provider Name: SHAYNA JO MICKELSEN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 530 S HOLMES AVE
    IDAHO FALLS, ID
    ZIP 83401
  • Phone: (208) 529-2352

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NPI Details

Shayna Jo Mickelsen is a family nurse practitioner in Idaho Falls, ID. Shayna Jo Mickelsen NPI is 1639024888. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

530 S HOLMES AVE
IDAHO FALLS, ID
ZIP 83401-056
Phone: (208) 529-2352

The enumeration date for this NPI number is 3/3/2026 and was last updated on 3/3/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily1081001IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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