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NPI Code Detail

MEDICARE: MIHRET GELETA

MEDICARE: MIHRET GELETA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramMN
2363A00000XPhysician AssistantMN

General Provider Information

NPI Number : 1730011081
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIHRET GELETA
Provider Business Mailing Address
First Line : 630 CLEVELAND AVE SW APT 7
Second Line :
City : NEW BRIGHTON
State : MN
Zip : 55112-3548
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2211 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-7505
Country : US
Telephone Number : 612-330-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ MIHRET GELETA ” Practice Location

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