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Individual
SETH JACOB TATE
Active
Individual
SETH JACOB TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
201150077NP
OR
363LF0000X
Family Nurse Practitioner
6170200-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
AP4637
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-1828
MEDICARE
—
05
—
731654
—
AZ
01
—
Z61788
MEDICARE
—
01
—
Z90637
MEDICARE
—
Enumeration date
08/29/2011
Last updated
04/17/2025
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