Provider Demographics
NPI:1376566588
Name:TATE, JANET MARY (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MARY
Last Name:TATE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:MISS
Other - First Name:JANET
Other - Middle Name:MARY
Other - Last Name:DEIGNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN RNFA
Mailing Address - Street 1:9901 E FLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208
Mailing Address - Country:US
Mailing Address - Phone:480-354-3051
Mailing Address - Fax:480-354-4083
Practice Address - Street 1:4440 N 36TH ST
Practice Address - Street 2:STE #200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018
Practice Address - Country:US
Practice Address - Phone:480-330-3850
Practice Address - Fax:480-396-6939
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN136992163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse