Provider Demographics
NPI:1518678994
Name:BURKHOLDER, NOELLE ANN CELIS (NP)
Entity type:Individual
Prefix:MRS
First Name:NOELLE ANN
Middle Name:CELIS
Last Name:BURKHOLDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:NOELLE
Other - Middle Name:ANN
Other - Last Name:BUCARIZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1810 WHITE CIR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5835
Mailing Address - Country:US
Mailing Address - Phone:478-228-6407
Mailing Address - Fax:
Practice Address - Street 1:1810 WHITE CIR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-5835
Practice Address - Country:US
Practice Address - Phone:678-797-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN271215163WE0003X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency