Provider Demographics
NPI:1851097810
Name:PATE, MELINDA SUE (APRN)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:SUE
Last Name:PATE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-8400
Mailing Address - Country:US
Mailing Address - Phone:517-924-1444
Mailing Address - Fax:
Practice Address - Street 1:605 W CHICAGO RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-8400
Practice Address - Country:US
Practice Address - Phone:517-924-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704274570363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care