Provider Demographics
NPI:1932719788
Name:TRUCKENMILLER, CELESTE MARIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:MARIE
Last Name:TRUCKENMILLER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:MARIE
Other - Last Name:KRIENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5445 LANARK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-8694
Mailing Address - Country:US
Mailing Address - Phone:484-637-6262
Mailing Address - Fax:
Practice Address - Street 1:5445 LANARK RD STE 100
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8694
Practice Address - Country:US
Practice Address - Phone:484-637-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN685773163W00000X
PASP022443363LF0000X
PASPO22443363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily