Individual
STEFANIE SMITH TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 PROFESSIONAL DR, MACON, GA 31201-1411
(478) 741-3007
(478) 330-6288
Mailing address
550 PROFESSIONAL DR, MACON, GA 31201-1411
(478) 741-3007
(478) 330-6288
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN183587
GA
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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