Individual
MRS. KIMBERLY ANN TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-6719
Mailing address
6706 W FRIENDLY AVE UNIT 1L, GREENSBORO, NC 27410-4049
(336) 508-5766
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
124098
NC
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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