Individual
DESTINEE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 ROCK MAPLE LN, RALEIGH, NC 27603
(919) 413-0422
Mailing address
108 ROCK MAPLE LN, RALEIGH, NC 27603
(919) 413-0422
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
280511
NC
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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