Provider Demographics
NPI:1558381228
Name:TATE, EBONY S (CNM)
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:S
Last Name:TATE
Suffix:
Gender:F
Credentials:CNM
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Other - Credentials:
Mailing Address - Street 1:101 HUNT DR
Mailing Address - Street 2:PO BOX 367
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-3497
Mailing Address - Country:US
Mailing Address - Phone:919-693-2141
Mailing Address - Fax:919-603-0480
Practice Address - Street 1:511 RUIN CREEK RD STE 101
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5919
Practice Address - Country:US
Practice Address - Phone:252-492-8576
Practice Address - Fax:252-492-7464
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2013-09-05
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Provider Licenses
StateLicense IDTaxonomies
NC347367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife