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Mrs. Melissa Thibault Mikota, APRN,FNP-BC
Family Nurse Practitioner in Third Lake, Illinois
NPI 1346673910

Melissa Thibault Mikota is a Family Nurse Practitioner based in Third Lake, IL and is specialized in Family. Melissa Thibault Mikota practices in Third Lake, IL and has the professional credentials of APRN,FNP-BC. The NPI Number for Melissa Thibault Mikota is 1346673910 and holds a License No. AP133930 (Illinois).

The current practice location address for Melissa Thibault Mikota is 34344 N Us Highway 45, Third Lake, IL and can be reached out via phone at 847-543-5440.

Location: 34344 N Us Highway 45, Third Lake, IL, 60030-4031
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Provider Profile Details
NPI Number
1346673910
Provider Name
Melissa Thibault Mikota
Credential
APRN,FNP-BC
Provider Entity Type
Individual
Gender
Female
Address
34344 N Us Highway 45, Third Lake, IL, 60030-4031
Phone Number
847-543-5440
Fax Number
Provider Enumeration Date
08/18/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1346673910 05 WA
G8923564 01 WA MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
34344 N Us Highway 45
City
State
Zip
60030-4031
Phone Number
847-543-5440
Fax Number
person
Provider Business Mailing Address Details
Address
34344 N Us Highway 45
City
State
Zip
60030-4031
Phone Number
847-543-5440
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
AP133930 (Texas)
Definition
Definition to come...
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