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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

LYSTRA B WILSON CELESTINE, MD
280 SIERRA COLLEGE DR STE 115
GRASS VALLEY, CA95945
 Phone: 530-477-3119
 Fax: 530-274-2077
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for LYSTRA B WILSON CELESTINE · (Female)

NPI Number 1003034018
Status Active
Credentials MD
Entity Individual
Enumeration date 04/23/2007
Last updated 05/29/2018 - More than a year ago
Sole proprietor 1 No
Identifiers
  • WA License # MD00048034
Hospital affiliation(s)
  • SIERRA NEVADA MEMORIAL HOSPITAL - (Acute Care)
    155 GLASSON WAY
    GRASS VALLEY, CA 95945
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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