Individual
BRENNA L TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1680 DIAGONAL RD, WORTHINGTON, MN 56187-1008
(507) 372-3800
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R192172-2
MN
Other
Enumeration date
09/23/2009
Last updated
01/18/2010
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