Individual
MS. TERESA LYNN TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,BC
Contact information
Practice address
106 LOCKHEED DR, BEAVER, WV 25813-8962
(304) 253-5155
(691) 207-7011
Mailing address
106 LOCKHEED DR, BEAVER, WV 25813-8962
(304) 253-5155
(304) 536-5031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
51350
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1611
RXA
WV
05
—
3810007225
—
WV
Enumeration date
05/15/2006
Last updated
10/26/2022
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