Individual
AMBER NICOLE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PMHNP-BC
Contact information
Practice address
15521 MIDLOTHIAN TPKE, SUITE 105, MIDLOTHIAN, VA 23113-7312
(804) 423-1550
Mailing address
15521 MIDLOTHIAN TPKE, SUITE 105, MIDLOTHIAN, VA 23113-7312
(804) 423-1550
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024173791
VA
Other
Enumeration date
08/02/2016
Last updated
11/16/2016
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