Provider Demographics
NPI:1740736263
Name:PATE, CHRISTOPHER ALLEN (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:PATE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:ALLEN
Other - Middle Name:
Other - Last Name:PATE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:907 18TH ST E STE 400
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-3684
Mailing Address - Country:US
Mailing Address - Phone:229-353-3422
Mailing Address - Fax:229-353-6060
Practice Address - Street 1:1815 OLD OCILLA RD
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-1617
Practice Address - Country:US
Practice Address - Phone:229-391-3535
Practice Address - Fax:229-391-3529
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN172215363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily