Individual
REBECCA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
503 N MAPLE ST, EFFINGHAM, IL 62401-2006
(217) 342-2121
Mailing address
503 N MAPLE ST, EFFINGHAM, IL 62401-2006
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209015692
IL
Other
Enumeration date
03/01/2017
Last updated
11/12/2024
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