Provider Demographics
NPI:1326324591
Name:TATE, MARCIA WINNIES (RD)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:WINNIES
Last Name:TATE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2177 ASHEVILLE RD
Mailing Address - Street 2:HAYWOOD COUNTY HEALTH DEPARTMENT
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786
Mailing Address - Country:US
Mailing Address - Phone:828-452-6675
Mailing Address - Fax:828-452-6730
Practice Address - Street 1:2177 ASHEVILLE RD
Practice Address - Street 2:HAYWOOD COUNTY HEALTH DEPARTMENT
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786
Practice Address - Country:US
Practice Address - Phone:828-452-6675
Practice Address - Fax:828-452-6730
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003828133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered