Provider Demographics
NPI:1710326814
Name:WARLICK, CELESTE M (NP)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:M
Last Name:WARLICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14231 BEADLE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-8213
Mailing Address - Country:US
Mailing Address - Phone:269-962-0441
Mailing Address - Fax:269-962-0925
Practice Address - Street 1:5218 BECK DR STE 12
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-9132
Practice Address - Country:US
Practice Address - Phone:574-335-7700
Practice Address - Fax:574-335-0737
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704299445363LF0000X
IN71008679363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300021600Medicaid