Provider Demographics
NPI:1467849489
Name:BARGATZE, CELESTA RHEA (CPM-TN)
Entity Type:Individual
Prefix:
First Name:CELESTA
Middle Name:RHEA
Last Name:BARGATZE
Suffix:
Gender:F
Credentials:CPM-TN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CAPITAL ST
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-2406
Mailing Address - Country:US
Mailing Address - Phone:615-668-8754
Mailing Address - Fax:877-482-7311
Practice Address - Street 1:220 CAPITAL ST
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-2406
Practice Address - Country:US
Practice Address - Phone:615-668-8754
Practice Address - Fax:877-482-7311
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN66176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife