Charles, Carolyn Celestine

Charles, Carolyn Celestine is an individual health care provider with primary practice located at 106 Circle Way St , Lake Jackson TX 77566-5266. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Charles, Carolyn Celestine can be contacted via phone (979) 824-8291.

Contact Information

Primary practice address
106 Circle Way St Lake Jackson TX 77566-5266
Phone: (979) 824-8291
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 143100 Texas

Profile Details

NPI number 1124678511
LBN Legal business name Charles, Carolyn Celestine
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2019
Last updated Sep 17th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124678511 NPPES
Texas MEDICAID 143100

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