Individual
MRS. TIFFANY REED TATE-WOODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
2420 STATE ST, EAST SAINT LOUIS, IL 62205-2321
(618) 318-8809
(618) 615-4205
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(618) 318-8809
(618) 615-4205
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
209.026757
IL
Other
Enumeration date
01/10/2020
Last updated
01/08/2026
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