Provider Demographics
NPI:1619962826
Name:SCHULTZ, CELESTE M (RNC MS CPNP)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:M
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:RNC MS CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4231
Mailing Address - Country:US
Mailing Address - Phone:419-473-3561
Mailing Address - Fax:
Practice Address - Street 1:3949 SUNFOREST CT
Practice Address - Street 2:STE 203 TWIN OAKS PEDIATRICS
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4473
Practice Address - Country:US
Practice Address - Phone:419-292-0191
Practice Address - Fax:419-292-0589
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN149235363LP0200X
OHNP00066363LP0200X
OHCTP00066RX363LP0200X
MI4704139413363LP0200X
MI1493086363LP0200X
MI1492748363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2054397Medicaid
OHNP38611Medicare PIN