Healthcare Provider Details

I. General information

NPI: 1407746399
Provider Name (Legal Business Name): CHRISTY LOVE CELESTIE CERTIFIED NURSING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTY L CELESTIE CNA

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SONRISE PL APT 203
FELLSMERE FL
32948-5375
US

IV. Provider business mailing address

75 SONRISE PL APT 203
FELLSMERE FL
32948-5375
US

V. Phone/Fax

Practice location:
  • Phone: 772-300-4136
  • Fax:
Mailing address:
  • Phone: 772-300-4136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number409579
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number409579
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: