Individual
DEBORAH SUSAN TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4347 LAKE FRONT BLVD, MYRTLE BEACH, SC 29588-9666
(681) 753-8815
Mailing address
4347 LAKE FRONT BLVD, MYRTLE BEACH, SC 29588-9666
(681) 753-8815
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
76800
WV
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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