MEDICARE: CELESTE MYERS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse	13402891-3102	UT

General Provider Information

NPI Number	:	1295684264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELESTE MYERS RN

Provider Business Mailing Address
First Line	:	8822 S REDWOOD RD STE C212
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-5692
Country	:	US
Telephone Number	:	801-649-8389
Fax Number	:

Provider Business Practice Location Address
First Line	:	8822 S REDWOOD RD STE C212
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-5692
Country	:	US
Telephone Number	:	801-649-8389
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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