Individual
JUSTIN TIMOTHY PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
305 LANGDON ST, SOMERSET, KY 42503-2750
(606) 678-3288
Mailing address
1105 PLEASANT GROVE RIDGE RD, MOUNT EDEN, KY 40046-9510
(502) 680-7048
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3013814
KY
Other
Enumeration date
09/15/2019
Last updated
09/15/2019
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