Provider Demographics
NPI:1770104911
Name:BROWN, CELESTE INDVIK (NP)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:INDVIK
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:DANIELLE
Other - Last Name:INDVIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:316 MID VALLEY CTR STE 186
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2-2527 KAUMUALII HWY
Practice Address - Street 2:
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741-8309
Practice Address - Country:US
Practice Address - Phone:808-332-5580
Practice Address - Fax:808-332-5581
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2024-08-01
Deactivation Date:2024-07-12
Deactivation Code:
Reactivation Date:2024-07-31
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily