Healthcare Provider Details

I. General information

NPI: 1912834417
Provider Name (Legal Business Name): ALDIJANA CELEBIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

9130 NEMO DR
SAINT LOUIS MO
63123-5531
US

IV. Provider business mailing address

9130 NEMO DR
SAINT LOUIS MO
63123-5531
US

V. Phone/Fax

Practice location:
  • Phone: 314-578-8068
  • Fax:
Mailing address:
  • Phone: 314-578-8068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2026012432
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: