Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | VP003246M | PA |
NPI | 1043492705 |
---|---|
Provider Name | Michele Celko |
First Address | Vandergrift, PA 15690-8023 |
Second Address | Pittsburgh, PA 15213-2536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2007 |
Last Update Date | 27/04/2016 |