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General NPI Number Information
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NPI Number | 1396235529
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Entity Type | Individual
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Provider Name | KELSIE JEAN MITTEREDER DO
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Gender | Female
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 2580 HAYMAKER RD STE 201
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City | MONROEVILLE
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State | PA
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Zip | 15146-3500
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Country | US
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Telephone | 412-856-7500
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Fax | 412-856-6079
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Provider Business Mailing Address
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Address Line | 2580 HAYMAKER RD STE 201
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City | MONROEVILLE
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State | PA
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Zip | 15146-3500
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Country | US
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Telephone | 412-856-7500
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Fax | 412-856-6079
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | OS022138
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License Number State | PA
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