Individual
AMANDA TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
59 GRANT ST, NEWARK, OH 43055-3939
(740) 349-7511
Mailing address
1801 WATERMARK DR, COLUMBUS, OH 43215-7088
(614) 487-8758
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.471290
OH
164W00000X
Licensed Practical Nurse
Primary
RN.471290
OH
Other
Enumeration date
04/02/2026
Last updated
04/10/2026
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