Provider Demographics
NPI:1346738176
Name:ROSS, CELESTE ELAINE (CRNA)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:ELAINE
Last Name:ROSS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:ELAINE
Other - Last Name:MOOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3914 ACCRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3884
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7101 S PADRE ISLAND DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4913
Practice Address - Country:US
Practice Address - Phone:361-761-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143913367500000X
COC-APN.0001058-C-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered