Individual
CELESTA LEE CUSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN/INF
Contact information
Practice address
701 N LEXINGTON AVE, WILMORE, KY 40390-1138
(724) 456-1268
Mailing address
701 N LEXINGTON AVE, WILMORE, KY 40390-1138
(724) 456-1268
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1104010
KY
163W00000X
Registered Nurse
127909
AK
163W00000X
Registered Nurse
Primary
888130
MS
Other
Enumeration date
06/04/2019
Last updated
10/13/2019
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