Individual
NATHAN JOHN MITTLESTEADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1300
(502) 634-6767
Mailing address
10706 IMPATIENS ST, PROSPECT, KY 40059-7542
(850) 450-8750
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC058
KY
Other
Enumeration date
12/01/2010
Last updated
11/14/2022
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