Individual
MRS. LISA MARIE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
975 RYLAND ST, STE 100, RENO, NV 89502-1667
(775) 982-5000
(775) 982-5225
Mailing address
780 KUENZLI ST, STE 202, RENO, NV 89502-0845
(775) 982-5068
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN000913
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12188992
CAQH
—
05
—
1265561021
—
NV
Enumeration date
03/05/2007
Last updated
09/23/2014
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