Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mikaela Sue Jorgensen, MAT, LAT, ATC

Individual provider Athletic Trainer · NPI 1639944408

Mikaela Sue Jorgensen, MAT, LAT, ATC is an Athletic Trainer in Provo, Utah. Licensed in Utah. Registered with an NPI since 2023.

Licensed in
UT
In the registry since
2023
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

150 E Bulldog Blvd
Provo, UT 84604-2676
Phone: (801) 422-4636
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 13416952-4810 (UT)

Record details

NPI number1639944408
Entity typeIndividual (Type 1)
GenderFemale
Credentials MAT , LAT , ATC
Sole proprietorNo
NPI enumeratedNovember 21, 2023
Last updated in NPPESNovember 21, 2023
Certification dateNovember 21, 2023

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