Healthcare Provider Details

I. General information

NPI: 1992753511
Provider Name (Legal Business Name): CELESTE A CHRISTENSEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 REGENCY ROAD
LEXINGTON KY
40503-2925
US

IV. Provider business mailing address

PO BOX 737100
CHICAGO IL
60673-6374
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-1316
  • Fax: 859-278-9896
Mailing address:
  • Phone: 859-278-1316
  • Fax: 859-278-9896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA438
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA438
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: