Provider Demographics
NPI:1790542090
Name:PATE, JAYCIE WILLIAMS (MSN-FNP)
Entity type:Individual
Prefix:MRS
First Name:JAYCIE
Middle Name:WILLIAMS
Last Name:PATE
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-765-5221
Mailing Address - Fax:336-765-0430
Practice Address - Street 1:825 W HENDERSON ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2725
Practice Address - Country:US
Practice Address - Phone:704-637-1123
Practice Address - Fax:704-637-1214
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019716363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner