Provider Demographics
NPI:1518347285
Name:CELESTINO, CHRISTINA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CELESTINO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14155 N 83RD AVE
Mailing Address - Street 2:STE 127
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-5639
Mailing Address - Country:US
Mailing Address - Phone:623-203-6846
Mailing Address - Fax:
Practice Address - Street 1:14155 N 83RD AVE
Practice Address - Street 2:STE 127
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5639
Practice Address - Country:US
Practice Address - Phone:623-203-6846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2015-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily