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General NPI Number Information
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NPI Number | 1053273045
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Entity Type | Individual
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Provider Name | LESVIA LINETH CELEDON-VILLARREAL
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Gender | Female
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Dates
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Enumeration Date | 11/27/2025
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Last Update Date | 11/27/2025
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Provider Practice Location Address
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Address Line | 305 RACINE ST
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City | MENASHA
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State | WI
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Zip | 54952-2359
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Country | US
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Telephone | 920-722-4759
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Fax |
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Provider Business Mailing Address
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Address Line | 8437 MARLO AVE UNIT 7
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City | NEENAH
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State | WI
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Zip | 54956-3287
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 76449
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 103280-875
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License Number State | WI
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