Provider Demographics
NPI:1104384353
Name:CELESTIAL MIDWIFERY SERVICES LLC
Entity Type:Organization
Organization Name:CELESTIAL MIDWIFERY SERVICES LLC
Other - Org Name:SHEILA DELL CNM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:DINEASE
Authorized Official - Last Name:DELL
Authorized Official - Suffix:
Authorized Official - Credentials:CNM,MSN
Authorized Official - Phone:864-203-5588
Mailing Address - Street 1:24 MAXWELL RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5419
Mailing Address - Country:US
Mailing Address - Phone:864-203-5588
Mailing Address - Fax:877-243-1872
Practice Address - Street 1:24 MAXWELL RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5419
Practice Address - Country:US
Practice Address - Phone:864-203-5588
Practice Address - Fax:877-243-1872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305S00000XManaged Care OrganizationsPoint of ServiceGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP9104Medicaid
CA1104106442OtherNPI
MDCNM0282OtherAMCB
CAMW0426Medicaid
SCAPN20137OtherBOARD OF NURSING SC