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General NPI Number Information
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NPI Number | 1871428565
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Entity Type | Individual
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Provider Name | CELIA ELLEN SEMRAD PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 2230 N RESERVE ST STE 402
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City | MISSOULA
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State | MT
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Zip | 59808-1364
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Country | US
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Telephone | 406-721-0533
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Fax |
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Provider Business Mailing Address
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Address Line | 4283 BLACKSTONE CT
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City | MIDDLETON
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State | WI
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Zip | 53562-4300
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Country | US
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Telephone | 608-695-4707
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MED-PAC-LIC-174225
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License Number State | MT
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