Provider Demographics
NPI:1184026858
Name:CELIS, ASHLEY (ANP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:CELIS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 W 106TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2305
Mailing Address - Country:US
Mailing Address - Phone:913-541-5500
Mailing Address - Fax:913-541-7474
Practice Address - Street 1:12200 W 106TH ST STE 235
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2368
Practice Address - Country:US
Practice Address - Phone:913-541-3540
Practice Address - Fax:913-541-7474
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014032501363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2014032501OtherLICENSE