Provider Demographics
NPI:1588217657
Name:JONES, CELESTE AMANDA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:AMANDA
Last Name:JONES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47352-0271
Mailing Address - Country:US
Mailing Address - Phone:765-591-6973
Mailing Address - Fax:
Practice Address - Street 1:1000 VAN NUYS RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-9060
Practice Address - Country:US
Practice Address - Phone:765-593-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28174151A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health