Davis, Celeste

Davis, Celeste is an individual health care provider with primary practice located at 297 Cooper Rd , Loganville GA 30052-2518. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Davis, Celeste can be contacted via phone (678) 381-2630.

Contact Information

Primary practice address
297 Cooper Rd Loganville GA 30052-2518
Phone: (678) 381-2630
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN232264 Georgia

Profile Details

NPI number 1417425513
LBN Legal business name Davis, Celeste
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2018
Last updated Aug 4th, 2020 - about 4 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 1417425513 NPPES
Georgia MEDICAID 003215265A

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