Provider Demographics
NPI:1598096059
Name:TATE, JEFLYN D (WHNP)
Entity Type:Individual
Prefix:MS
First Name:JEFLYN
Middle Name:D
Last Name:TATE
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 E. HOUSTON ST SUITE B
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4542
Mailing Address - Country:US
Mailing Address - Phone:281-593-1660
Mailing Address - Fax:281-593-0730
Practice Address - Street 1:300 E HOUSTON ST
Practice Address - Street 2:STE B
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4554
Practice Address - Country:US
Practice Address - Phone:281-593-1660
Practice Address - Fax:281-593-0730
Is Sole Proprietor?:No
Enumeration Date:2010-01-23
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4-52071363LW0102X
TX452071363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health