Provider Demographics
NPI:1740026459
Name:ARAGON, MIKAEL (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:MIKAEL
Middle Name:
Last Name:ARAGON
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:STAYTON
Mailing Address - State:OR
Mailing Address - Zip Code:97383-2104
Mailing Address - Country:US
Mailing Address - Phone:402-613-2212
Mailing Address - Fax:
Practice Address - Street 1:1100 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-2104
Practice Address - Country:US
Practice Address - Phone:402-613-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10028818363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily