Individual
SUNDI ELAINA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
2901 TELESTAR CT # 600, FALLS CHURCH, VA 22042-1260
(703) 621-4503
(703) 766-5921
Mailing address
2901 TELESTAR CT STE 300, FALLS CHURCH, VA 22042-1263
(703) 591-1688
(703) 591-1445
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024172770
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497121982
—
VA
Enumeration date
08/19/2015
Last updated
04/25/2024
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