Healthcare Provider Details

I. General information

NPI: 1548052756
Provider Name (Legal Business Name): ANDREINA CELEDON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6233 PALMYRA AVE
LAS VEGAS NV
89146-6651
US

IV. Provider business mailing address

6233 PALMYRA AVE
LAS VEGAS NV
89146-6651
US

V. Phone/Fax

Practice location:
  • Phone: 702-410-7825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number837802
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number837802
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: