Provider Demographics
NPI:1942775796
Name:CELESTE, MICHELLE S (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:CELESTE
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:MICHELLE STEPHANIE I
Other - Middle Name:T
Other - Last Name:CELESTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, APRN, FNP-C
Mailing Address - Street 1:3835 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-7125
Mailing Address - Country:US
Mailing Address - Phone:702-880-4193
Mailing Address - Fax:
Practice Address - Street 1:3835 S JONES BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103
Practice Address - Country:US
Practice Address - Phone:702-880-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV812118363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner