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NPI Code Detail

MEDICARE: REBECCA JILL PATE M.D.

MEDICARE: REBECCA JILL PATE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician25844TN
22084P0800XPsychiatry Physician25844TN

General Provider Information

NPI Number : 1164428785
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA JILL PATE M.D.
Provider Business Mailing Address
First Line : 2042 ALEXANDER BLVD
Second Line :
City : MURFREESBORO
State : TN
Zip : 37130-9016
Country : US
Telephone Number : 615-479-7047
Fax Number :
Provider Business Practice Location Address
First Line : 2495 SHREVEPORT HWY
Second Line :
City : PINEVILLE
State : LA
Zip : 71360-4044
Country : US
Telephone Number : 318-473-0010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 09/28/2023

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