Healthcare Provider Details

I. General information

NPI: 1346505674
Provider Name (Legal Business Name): CELINA HARGENRADER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 MOZART DR
HOUMA LA
70363-7990
US

IV. Provider business mailing address

189 MOZART DR
HOUMA LA
70363-7990
US

V. Phone/Fax

Practice location:
  • Phone: 985-868-3700
  • Fax:
Mailing address:
  • Phone: 985-868-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP06879
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110594-6879
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: