Individual
KYLEE ROSE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16635 N 43RD AVE # 100, PHOENIX, AZ 85053-2707
(480) 553-6168
Mailing address
16635 N 43RD AVE # 100, PHOENIX, AZ 85053-2707
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
04/22/2024
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