Individual
LATOYA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
128 BRAEBURN BLVD, RICHLANDS, NC 28574-8463
(252) 241-5678
Mailing address
128 BRAEBURN BLVD, RICHLANDS, NC 28574-8463
(252) 241-5678
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
203583
NC
163W00000X
Registered Nurse
781522
CA
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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