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General NPI Number Information
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NPI Number | 1003426107
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Entity Type | Individual
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Provider Name | CELENA BOUNVILAY PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 480 W WEBB AVE
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City | BURLINGTON
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State | NC
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Zip | 27217-3700
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Country | US
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Telephone | 336-226-8000
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Fax | 336-228-7585
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Provider Business Mailing Address
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Address Line | 1913 BROADWAY DR
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City | GRAHAM
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State | NC
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Zip | 27253-4326
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-10364
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License Number State | NC
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