Provider Demographics
NPI:1356402895
Name:TATE, JANET M (RN)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:M
Last Name:TATE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18020 BEAR SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-8602
Mailing Address - Country:US
Mailing Address - Phone:937-642-4888
Mailing Address - Fax:
Practice Address - Street 1:18020 BEAR SWAMP RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-8602
Practice Address - Country:US
Practice Address - Phone:937-642-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 109189163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2337608Medicaid