Individual
MARIAN K TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
137 KANSAS STREET, WALSH, CO 81090-0608
(719) 324-5253
(719) 324-5621
Mailing address
137 KANSAS ST, PO BOX 608, WALSH, CO 81090-0608
(719) 324-5253
(719) 324-5621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
44312
KS
363LF0000X
Family Nurse Practitioner
Primary
54031
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100282330A
—
KS
05
—
72000856
—
CO
Enumeration date
10/02/2006
Last updated
07/23/2010
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