Individual
CELESTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
151 SAMMIS AVE, DEER PARK, NY 11729-6719
(917) 664-9932
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(917) 664-9932
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
343925
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
26NJ01084700
NJ
Other
Enumeration date
01/14/2019
Last updated
02/16/2024
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