Individual
KATHLEEN MICHELE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2412 MEADOW OAK, FLOWOOD, MS 39232-8780
(601) 986-1051
Mailing address
971 LAKELAND DR, STE 1460, JACKSON, MS 39216-4621
(601) 982-3202
(601) 982-3259
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
904614
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/22/2020
Last updated
04/08/2024
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