Individual
TAMMY TATE-GOBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 494-2121
(337) 494-2360
Mailing address
PO BOX 1395, LAKE CHARLES, LA 70602-1395
(337) 494-2121
(337) 494-2360
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APO4589
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1594873
—
LA
01
—
P00214394
RRMEDICARE
LA
Enumeration date
05/10/2006
Last updated
06/17/2022
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