Provider Demographics
NPI:1558688713
Name:CELEK, PATRICIA JEAN (RN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JEAN
Last Name:CELEK
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W351N5304 ROAD C
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-2566
Mailing Address - Country:US
Mailing Address - Phone:262-567-9748
Mailing Address - Fax:
Practice Address - Street 1:8901 W. LINCOLN AVENUE
Practice Address - Street 2:AWAMC
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227
Practice Address - Country:US
Practice Address - Phone:414-328-6198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI127459-030163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator