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General NPI Number Information
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NPI Number | 1407502420
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Entity Type | Individual
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Provider Name | CELESTE RENEE CHRISTIANSEN FNP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1120 S RACKHAM WAY
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City | MERIDIAN
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State | ID
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Zip | 83642-1092
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Country | US
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Telephone | 208-577-8672
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Fax | 208-209-6058
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Provider Business Mailing Address
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Address Line | 165 E LAKEVIEW DR
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City | CLEARFIELD
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State | UT
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Zip | 84015-2394
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Country | US
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Telephone | 801-830-7227
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 6072992-3102
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2871562
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License Number State | ID
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