Provider Demographics
NPI:1346643954
Name:GROENENBERG, CELESTE RENEE (CPM, LM)
Entity Type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:RENEE
Last Name:GROENENBERG
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:RENEE
Other - Last Name:FLATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8000 WERKNER ROAD
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-9145
Mailing Address - Country:US
Mailing Address - Phone:734-747-0205
Mailing Address - Fax:734-480-8827
Practice Address - Street 1:8000 WERKNER ROAD
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-9145
Practice Address - Country:US
Practice Address - Phone:734-747-0205
Practice Address - Fax:734-480-8827
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7601000033176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife