Provider Demographics
NPI:1386409274
Name:SMITH, CELESTE JEAN (MSN, APRN, ACNPC-BC)
Entity type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:JEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN, APRN, ACNPC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-1922
Mailing Address - Country:US
Mailing Address - Phone:313-258-6648
Mailing Address - Fax:
Practice Address - Street 1:3410 WORTH ST STE 545
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2003
Practice Address - Country:US
Practice Address - Phone:469-472-8676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1124031363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care