Individual
JOSE MANUEL CELEDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
508 E FLORIDA AVE, NAMPA, ID 83686-5823
(208) 463-0118
Mailing address
2226 E SHADY GLADE DR, MERIDIAN, ID 83642-8245
(208) 989-6483
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
59029
ID
Other
Enumeration date
08/31/2018
Last updated
07/18/2022
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