Provider Demographics
NPI:1407953979
Name:NASSIF, CECELIA M (ARNP)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:M
Last Name:NASSIF
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 SOUTH KELLOGG
Mailing Address - Street 2:SUITE 1
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010
Mailing Address - Country:US
Mailing Address - Phone:515-232-9020
Mailing Address - Fax:515-956-3310
Practice Address - Street 1:126 SOUTH KELLOGG
Practice Address - Street 2:SUITE 1
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010
Practice Address - Country:US
Practice Address - Phone:515-232-9020
Practice Address - Fax:515-956-3310
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC049851363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0220723Medicaid
IAC049851OtherNURSE PRACTITIONER LICENS