Provider Demographics
NPI:1497403588
Name:CELIS, CLAUDIA FABIOLA (DNP)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:FABIOLA
Last Name:CELIS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:FABIOLA
Other - Last Name:CELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:189 W PLEASANT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2209
Mailing Address - Country:US
Mailing Address - Phone:801-690-4127
Mailing Address - Fax:
Practice Address - Street 1:189 W PLEASANT VIEW DR
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84414-2209
Practice Address - Country:US
Practice Address - Phone:801-690-4127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10206869-3102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily