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

Shayna Jo Mickelsen

Individual provider Family Nurse Practitioner · NPI 1639024888

Shayna Jo Mickelsen is a Family Nurse Practitioner in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2026.

Licensed in
ID
In the registry since
2026

Practice location Address checks out

530 S Holmes Ave
Idaho Falls, ID 83401-5056
Phone: (208) 529-2352
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1081001 (ID)

Record details

NPI number1639024888
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 3, 2026
Last updated in NPPESMarch 3, 2026
Certification dateFebruary 4, 2026

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