Healthcare Provider Details

I. General information

NPI: 1235700949
Provider Name (Legal Business Name): CELINA ANN ACEVEDO-ADAMS AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2021
Last Update Date: 07/03/2021
Certification Date: 07/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E DUNLAP AVE
PHOENIX AZ
85020-2825
US

IV. Provider business mailing address

11838 W JESSIE LN
SUN CITY AZ
85373-5433
US

V. Phone/Fax

Practice location:
  • Phone: 602-943-2381
  • Fax: 480-882-5870
Mailing address:
  • Phone: 602-309-2933
  • Fax: 480-882-5870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number260282
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number260282
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: