MEDICARE: MS. JUDITH CELIK NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN088702	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	62305	OTHER	AZ	MERIDIAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225033491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH CELIK NP

Provider Business Mailing Address
First Line	:	6040 E MAIN ST
Second Line	:	# 220
City	:	MESA
State	:	AZ
Zip	:	85205-8928
Country	:	US
Telephone Number	:	602-390-6655
Fax Number	:	480-924-8256

Provider Business Practice Location Address
First Line	:	6040 E MAIN ST
Second Line	:	# 220
City	:	MESA
State	:	AZ
Zip	:	85205-8928
Country	:	US
Telephone Number	:	602-390-6655
Fax Number	:	480-924-8256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	03/04/2013

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