Individual
CELESTE GOOD WOOLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-1234
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01653
WV
363A00000X
Physician Assistant
Primary
2915
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072238
—
OH
01
—
7100219630
MEDICAID
KY
Enumeration date
08/09/2012
Last updated
07/20/2022
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