Provider Demographics
NPI:1134643216
Name:BASSETT, CELESTINA (NP)
Entity type:Individual
Prefix:MS
First Name:CELESTINA
Middle Name:
Last Name:BASSETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CELESTINA
Other - Middle Name:
Other - Last Name:APINERU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1035 KEPLER DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-8320
Mailing Address - Country:US
Mailing Address - Phone:920-490-9046
Mailing Address - Fax:
Practice Address - Street 1:2845 GREENBRIER RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311
Practice Address - Country:US
Practice Address - Phone:920-288-4848
Practice Address - Fax:920-288-4956
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7820-33363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily