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Individual

CARLA TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
8315 LEE HWY STE 202, FAIRFAX, VA 22031-2215
(703) 798-2695
Mailing address
6151 TAFFY CT, WOODBRIDGE, VA 22193-4182
(703) 798-2695

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024181100
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F03210455
AANP
VA
Enumeration date
03/25/2021
Last updated
03/26/2021
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