Healthcare Provider Details

I. General information

NPI: 1811414758
Provider Name (Legal Business Name): BONNIE CELLA MSN, RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15740 S OUTER 40 RD
CHESTERFIELD MO
63017-2004
US

IV. Provider business mailing address

15740 S OUTER 40 RD
CHESTERFIELD MO
63017-2004
US

V. Phone/Fax

Practice location:
  • Phone: 636-237-4700
  • Fax: 314-364-6350
Mailing address:
  • Phone: 636-237-4700
  • Fax: 314-364-6350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017005137
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: