Provider Demographics
NPI:1225867427
Name:CELESTIN, JEMIMA M (NP)
Entity type:Individual
Prefix:
First Name:JEMIMA
Middle Name:M
Last Name:CELESTIN
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:123 HIGHLAND AVE STE G2
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-1522
Mailing Address - Country:US
Mailing Address - Phone:888-344-4549
Mailing Address - Fax:908-652-9230
Practice Address - Street 1:123 HIGHLAND AVE STE G2
Practice Address - Street 2:
Practice Address - City:GLEN RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07028-1522
Practice Address - Country:US
Practice Address - Phone:888-344-4549
Practice Address - Fax:908-652-9230
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15098600363LG0600X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology