| Doctor Name: | MR. GEOFFREY JOHN MITTELSTEADT |
| NPI Number: | 1437315058 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ACUTE CARE NURSE PRA |
| License Number: | 16381 |
| Business Practice Address: | 5955 Zeamer Ave 673d Mdg Jber, AK - 995063702 |
| Business Phone Number: | 9075802506 |
| Business Fax Number: | |
| Mailing Address: | 5955 Zeamer Ave, 673d Mdg JBER |
| State: | AK |
| Postal Code: | 995063702 |
| Phone Number: | 9075802506 |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2008 |
| NPI Last Update Date: | 10/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 16381 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |