Provider Demographics
NPI:1114565793
Name:SAINT GEORGES ROSS, CELINE (NURSE)
Entity Type:Individual
Prefix:
First Name:CELINE
Middle Name:
Last Name:SAINT GEORGES ROSS
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 GOLF AVE
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-6221
Mailing Address - Country:US
Mailing Address - Phone:617-504-0457
Mailing Address - Fax:
Practice Address - Street 1:29 GOLF AVE
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6221
Practice Address - Country:US
Practice Address - Phone:617-504-0457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-14
Last Update Date:2019-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALVN64310164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse