Individual
CELESTE RENEE CHRISTESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
190 E BANNOCK ST FL 10, BOISE, ID 83712-6241
(208) 381-5500
(208) 381-2555
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8761579
ID
376K00000X
Nurse's Aide
ID000033431E
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/08/2022
Last updated
02/24/2025
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