Provider Demographics
NPI:1619329687
Name:MEKKELSEN, NORMAN BILLINGS III (NP)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:BILLINGS
Last Name:MEKKELSEN
Suffix:III
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PIONEER TRL
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1121
Mailing Address - Country:US
Mailing Address - Phone:952-361-3766
Mailing Address - Fax:
Practice Address - Street 1:111 PIONEER TRL
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1121
Practice Address - Country:US
Practice Address - Phone:952-361-3766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP4492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily