Basic Information
| Provider Information | |||||||||
| NPI: | 1558381228 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TATE | ||||||||
| FirstName: | EBONY | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 HUNT DR | ||||||||
| Address2: | PO BOX 367 | ||||||||
| City: | OXFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275653497 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196932141 | ||||||||
| FaxNumber: | 9196030480 | ||||||||
| Practice Location | |||||||||
| Address1: | 511 RUIN CREEK RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275365919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524928576 | ||||||||
| FaxNumber: | 2524927464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 09/05/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 347 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.