Individual
JESSIE TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8080 E CENTRAL AVE, SUITE 250, WICHITA, KS 67206-2368
(316) 686-7327
(316) 686-1557
Mailing address
8080 E CENTRAL AVE, SUITE 250, WICHITA, KS 67206-2368
(316) 686-7327
(316) 686-1557
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN0189836
CO
Other
Enumeration date
01/21/2016
Last updated
01/21/2016
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