Provider Demographics
NPI:1740983816
Name:KILMARTIN, CELESTE SIMS (RN)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:SIMS
Last Name:KILMARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:190 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-1238
Mailing Address - Country:US
Mailing Address - Phone:978-394-6761
Mailing Address - Fax:
Practice Address - Street 1:54 BAKER AVENUE EXT STE 305
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2143
Practice Address - Country:US
Practice Address - Phone:351-222-3088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2276061207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology