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Individual

DUDLEY W PATE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NPV

Contact information

Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
(423) 778-5179
(423) 778-2108
Mailing address
975 E 3RD ST # 159, CHATTANOOGA, TN 37403-2147
(423) 778-5179
(423) 778-2108

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26810
TN
363LG0600X
Gerontology Nurse Practitioner
26810
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26810
STATE APN LICENSURE
TN
Enumeration date
11/07/2019
Last updated
11/18/2019
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