Jose Manuel Celedon, NP
Nurse Practitioner, Gerontology in Nampa, ID. Individual provider (NPI-1).
NPI number1326520719
StatusActive
Last updated in NPPESJul 18, 2022
Details
- NPI
- 1326520719
- Entity type
- Individual (NPI-1)
- Name
- Jose Manuel Celedon
- Credential
- NP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 31, 2018
- Certification date
- Jul 18, 2022
- Last updated
- Jul 18, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | 59029 | ID | Yes |
Practice location
508 E Florida AveNampa, ID 83686-5823
Phone 208-463-0118
Mailing address
2226 E Shady Glade DrMeridian, ID 83642-8245
Phone 208-989-6483
Other practice locations
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