Provider Demographics
NPI:1912300740
Name:EGEMASI, CELINA A (FNP-C,PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CELINA
Middle Name:A
Last Name:EGEMASI
Suffix:
Gender:F
Credentials:FNP-C,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8380 WARREN PKWY STE 602
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4253
Mailing Address - Country:US
Mailing Address - Phone:469-200-4093
Mailing Address - Fax:469-200-4079
Practice Address - Street 1:11500 STATE HIGHWAY 121 STE 510
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-9348
Practice Address - Country:US
Practice Address - Phone:469-200-4093
Practice Address - Fax:469-200-4079
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126477363LF0000X, 363LP0808X
WAAP61400286363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily