Provider Demographics
NPI:1003323510
Name:TATE HEALTH AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:TATE HEALTH AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:775-636-8308
Mailing Address - Street 1:2005 SIERRA HIGHLANDS DR.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523
Mailing Address - Country:US
Mailing Address - Phone:775-636-8308
Mailing Address - Fax:775-386-6482
Practice Address - Street 1:2005 SIERRA HIGHLANDS DR.
Practice Address - Street 2:SUITE 101
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523
Practice Address - Country:US
Practice Address - Phone:775-636-8308
Practice Address - Fax:775-386-6482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN000913363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty