Healthcare Provider Details

I. General information

NPI: 1710326814
Provider Name (Legal Business Name): CELESTE M WARLICK N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 01/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5218 BECK DR STE 12
ELKHART IN
46516-9132
US

IV. Provider business mailing address

14231 BEADLE LAKE RD
BATTLE CREEK MI
49014-8213
US

V. Phone/Fax

Practice location:
  • Phone: 574-335-7700
  • Fax: 574-335-0737
Mailing address:
  • Phone: 269-962-0441
  • Fax: 269-962-0925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704299445
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008679
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: