Provider Demographics
NPI:1598320723
Name:BOSWORTH, CELESTE DIANA (ND)
Entity Type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:DIANA
Last Name:BOSWORTH
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11863 SPRINGS RD STE 255
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-7259
Mailing Address - Country:US
Mailing Address - Phone:303-335-9652
Mailing Address - Fax:
Practice Address - Street 1:11863 SPRINGS RD STE 255
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-7259
Practice Address - Country:US
Practice Address - Phone:303-335-9652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2022-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60913704175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath