Provider Demographics
NPI:1114566056
Name:CELANIA, MARCIA ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:ANNE
Last Name:CELANIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PARK LN
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-1426
Mailing Address - Country:US
Mailing Address - Phone:641-777-5065
Mailing Address - Fax:
Practice Address - Street 1:1140 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2017
Practice Address - Country:US
Practice Address - Phone:641-684-5467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist