Healthcare Provider Details

I. General information

NPI: 1255041745
Provider Name (Legal Business Name): CELINEX VARGAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2022
Last Update Date: 11/25/2022
Certification Date: 11/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 HAVERHILL ST
LAWRENCE MA
01841-4056
US

IV. Provider business mailing address

610 HAVERHILL ST
LAWRENCE MA
01841-4056
US

V. Phone/Fax

Practice location:
  • Phone: 978-273-2426
  • Fax:
Mailing address:
  • Phone: 978-273-2426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN2368861
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: