Healthcare Provider Details

I. General information

NPI: 1992179733
Provider Name (Legal Business Name): KELSEY JERGEL ZADROZNY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2015
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 FRIENDSHIP AVE
PITTSBURGH PA
15224-1722
US

IV. Provider business mailing address

4815 LIBERTY AVE STE 115
PITTSBURGH PA
15224-2156
US

V. Phone/Fax

Practice location:
  • Phone: 412-578-6808
  • Fax: 412-688-7517
Mailing address:
  • Phone: 412-578-6808
  • Fax: 412-688-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015636
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: