Celia A Hethke, RNC, ANP, APN
Individual provider Active NPI Adult Health Nurse Practitioner · Paxton, IL
NPI 1104922236 · NPPES record last updated May 22, 2012
Key facts
- NPI
- 1104922236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 041-171180 (IL)
- Practice address
- 227 N Market St
Paxton, IL 60957-1123 - Phone
- (217) 379-4864
- NPI assigned
- Sep 16, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-171180 | IL | MD | Adult Health Nurse Practitioner |
| 209-001278(41-17118) | IL | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 041-171180 | IL | Yes |
| Adult Health Nurse Practitioner | 363LA2200X | 209-001278(41-17118) | IL |
Addresses
Primary practice location
227 N Market St
Paxton, IL 60957-1123
Mailing address
112 Kendall St
Gifford, IL 61847-9602
Other providers in Paxton, IL
- Aubrey Glazik
- Leah Rae Hazelwood
- Hearing Matters, LLC
- Heartland of Paxton Il LLC
- Jill Herd
- Flavel Josef Heyman
- Tracey Hickox
- Douglas Charles Higgins
- Cheyenne Holt
- Gwyn L Howard
All providers in Paxton, IL · Adult Health Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.