Provider Demographics
NPI:1417833724
Name:PAULO, KEONAONA CELESTE (RN)
Entity type:Individual
Prefix:
First Name:KEONAONA
Middle Name:CELESTE
Last Name:PAULO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1573
Mailing Address - Street 2:
Mailing Address - City:JOSHUA TREE
Mailing Address - State:CA
Mailing Address - Zip Code:92252-0830
Mailing Address - Country:US
Mailing Address - Phone:303-562-8103
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1573
Practice Address - Street 2:
Practice Address - City:JOSHUA TREE
Practice Address - State:CA
Practice Address - Zip Code:92252-0830
Practice Address - Country:US
Practice Address - Phone:303-562-8103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95239634163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management