Provider Demographics
NPI:1376056622
Name:PATE, GENEVIEVE D (ARNP)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:D
Last Name:PATE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:D
Other - Last Name:PATE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:2376 DORA DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-2721
Mailing Address - Country:US
Mailing Address - Phone:727-744-7811
Mailing Address - Fax:
Practice Address - Street 1:25400 US HIGHWAY 19 N STE 201
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-2175
Practice Address - Country:US
Practice Address - Phone:727-669-6411
Practice Address - Fax:727-669-8231
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9283328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily