Provider Demographics
NPI:1548407976
Name:CELONY, EMANEZ D (LPN)
Entity Type:Individual
Prefix:MS
First Name:EMANEZ
Middle Name:D
Last Name:CELONY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:EMANEZ
Other - Middle Name:DARLIE
Other - Last Name:CELONY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:3806 MOUNT CARMEL LN
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-6712
Mailing Address - Country:US
Mailing Address - Phone:321-953-4710
Mailing Address - Fax:
Practice Address - Street 1:900 S FEDERAL HWY
Practice Address - Street 2:SUITE 305
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3725
Practice Address - Country:US
Practice Address - Phone:800-879-4471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5163533164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse