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SHAYNA JO MICKELSEN
NPI 1639024888
Nurse Practitioner - Family in Idaho Falls, ID

Active since March 03, 2026
530 S HOLMES AVE, IDAHO FALLS, ID 83401(208) 529-2352 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shayna Jo Mickelsen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAYNA JO MICKELSEN (NPI 1639024888) is an individual family provider in Idaho Falls, Idaho, licensed in Idaho (1081001) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1639024888
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHAYNA JO MICKELSEN
Location Address530 S HOLMES AVEIdaho Falls, ID 83401-5056
Mailing Address530 S Holmes AveIdaho Falls, ID 83401-5056 · (208) 529-2352
Phone(208) 529-2352
Sole ProprietorNo
Enumeration DateMarch 3, 2026
NPPES CertifiedFebruary 4, 2026
✔ NPI 1639024888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in ID · 1081001
530 S HOLMES AVE, Idaho Falls, ID 83401
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EYE CLINIC OF IDAHO FALLS,PA
Ophthalmology
530 S HOLMES AVE
IDAHO FALLS, ID 83401
Bonneville County (208) 529-3937
OPEN SPACE MENTAL HEALTH LLC
Psychiatry & Neurology (Psychiatry)
530 S HOLMES AVE
IDAHO FALLS, ID 83401
Bonneville County (307) 690-2938
JEANETTE MOSS SLATER FNP-C
Family Medicine
530 S HOLMES AVE
IDAHO FALLS, ID 83401
Bonneville County (208) 529-2352
CATHLEEN MARIE SMITH LMT
Massage Therapist
530 S HOLMES AVE
IDAHO FALLS, ID 83401
Bonneville County (208) 405-2888
BENJAMIN GARFIELD RAE IV
Nurse Practitioner (Psychiatric/Mental Health)
530 S HOLMES AVE
IDAHO FALLS, ID 83401
Bonneville County (208) 924-4360

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shayna Mickelsen's NPI number?

The NPI number for Shayna Mickelsen is 1639024888. It was assigned to this individual provider in the NPPES registry on March 3, 2026.

Where is Shayna Mickelsen located?

Shayna Mickelsen practices at 530 S Holmes Ave, Idaho Falls, ID 83401. The listed phone number is (208) 529-2352.

What is Shayna Mickelsen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Shayna Mickelsen was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.