Provider Demographics
NPI:1508366071
Name:DUARTE, CELIA (LVN)
Entity Type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:
Last Name:DUARTE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2781 S TRAVIS DR
Mailing Address - Street 2:
Mailing Address - City:FORT STOCKTON
Mailing Address - State:TX
Mailing Address - Zip Code:79735-8999
Mailing Address - Country:US
Mailing Address - Phone:432-290-1672
Mailing Address - Fax:
Practice Address - Street 1:2781 S TRAVIS DR
Practice Address - Street 2:
Practice Address - City:FORT STOCKTON
Practice Address - State:TX
Practice Address - Zip Code:79735-8999
Practice Address - Country:US
Practice Address - Phone:432-290-1672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX159213164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse