Individual
MARY LOUISE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
434 PIERCE LN, MONTROSS, VA 22520-2252
(804) 366-0913
Mailing address
434 PIERCE LN, MONTROSS, VA 22520-3121
(804) 366-0913
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
0024189538
VA
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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