Provider Demographics
NPI:1912788720
Name:SPENCER, CELESTE T
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:T
Last Name:SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ARMS BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-2761
Mailing Address - Country:US
Mailing Address - Phone:234-499-0776
Mailing Address - Fax:
Practice Address - Street 1:101 ARMS BLVD APT 3
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-2761
Practice Address - Country:US
Practice Address - Phone:234-499-0776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide