Individual
ANTONIANNETTE PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1750 E LAKE SHORE DR, DECATUR, IL 62521-3803
(217) 464-1440
Mailing address
PO BOX 193, BOODY, IL 62514-0193
(217) 853-5661
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.016156
IL
Other
Enumeration date
12/10/2017
Last updated
01/03/2022
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