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Individual
SANDRA TATE
Active
Individual
SANDRA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, PMNCNS-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
277.000849
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
277.000849
IL
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
277000849
IL
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
277-000849
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207988
GROUP
IL
01
—
CG2264
RR GROUP NUMBER
IL
01
—
P00220754
RR MEDICARE NUMBER
IL
Enumeration date
05/24/2006
Last updated
01/15/2026
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