Basic Information
Provider Information
NPI: 1497244016
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAIFER
FirstName: KELSEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 LOTHROP ST # G100
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152132536
CountryCode: US
TelephoneNumber: 4126924882
FaxNumber: 4126924555
Practice Location
Address1: 200 LOTHROP ST # G100
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152132536
CountryCode: US
TelephoneNumber: 4126924882
FaxNumber: 4126924555
Other Information
ProviderEnumerationDate: 05/09/2018
LastUpdateDate: 05/09/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP018605PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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