Provider Demographics
NPI:1760265995
Name:FINE, CELINA NOELLE (PA)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:NOELLE
Last Name:FINE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SIMS CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-1313
Mailing Address - Country:US
Mailing Address - Phone:303-912-4580
Mailing Address - Fax:
Practice Address - Street 1:50 SIMS CT
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-1313
Practice Address - Country:US
Practice Address - Phone:303-912-4580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant