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Individual

JENNA LEIGH TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
14050 NICOLLET AVE, SUITE 300, BURNSVILLE, MN 55337-5710
(952) 435-2450
(952) 892-0217
Mailing address
14829 MARYLAND AVE, SAVAGE, MN 55378-3637
(952) 457-2663

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
60599
MN
208000000X
Pediatrics Physician
R9745
IA

Other

Enumeration date
06/01/2013
Last updated
06/28/2016
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