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General NPI Number Information
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NPI Number | 1184235608
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Entity Type | Individual
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Provider Name | CELESTINE ATEAFACKTALEH
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Gender | Female
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 1495 MORSE RD STE 209C
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City | COLUMBUS
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State | OH
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Zip | 43229-6434
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Country | US
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Telephone | 614-260-8806
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 ROCHE DR STE 260B
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City | COLUMBUS
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State | OH
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Zip | 43229-3272
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Country | US
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Telephone | 614-260-8806
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0040292
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 462396
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License Number State | OH
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