Provider Demographics
NPI:1699827600
Name:MCKNIGHT, CELESTE TOLAR (FNP)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:TOLAR
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:FNP
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 1089
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-1089
Mailing Address - Country:US
Mailing Address - Phone:985-892-7070
Mailing Address - Fax:985-892-7017
Practice Address - Street 1:115 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-3034
Practice Address - Country:US
Practice Address - Phone:318-228-2415
Practice Address - Fax:318-335-3300
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN073799 AP04560363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1470031Medicaid
LA4H272Medicare ID - Type Unspecified
LA1470031Medicaid