=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699827600
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CELESTE TOLAR MCKNIGHT F.N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2007
-----------------------------------------------------
Last Update Date | 01/12/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 HOSPITAL DR
-----------------------------------------------------
City | OAKDALE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71463-3034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-228-2415
-----------------------------------------------------
Fax | 318-335-3300
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1089
-----------------------------------------------------
City | HAMMOND
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70404-1089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-892-7070
-----------------------------------------------------
Fax | 985-892-7017
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LC1500X
-----------------------------------------------------
Taxonomy Name | Community Health Nurse Practitioner
-----------------------------------------------------
License Number | RN073799 AP04560
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------