Provider Demographics
NPI:1659130771
Name:MEHL, MICHAEL CARL (MSN, RN)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CARL
Last Name:MEHL
Suffix:
Gender:M
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3220 N ACADEMY BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5115
Mailing Address - Country:US
Mailing Address - Phone:719-747-2084
Mailing Address - Fax:719-931-1323
Practice Address - Street 1:3220 N ACADEMY BLVD STE 3
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5115
Practice Address - Country:US
Practice Address - Phone:719-747-2084
Practice Address - Fax:719-931-1323
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1694254163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse