Provider Demographics
NPI:1750537221
Name:PATE, REBECCA BEVERLY (RNFA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:BEVERLY
Last Name:PATE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5216 LANTON DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-9003
Mailing Address - Country:US
Mailing Address - Phone:678-316-0161
Mailing Address - Fax:770-718-9593
Practice Address - Street 1:5216 LANTON DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-9003
Practice Address - Country:US
Practice Address - Phone:678-316-0161
Practice Address - Fax:770-718-9593
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN131482163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant