MEDICARE: CHANDRA R TATE FNP

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
1	363LF0000X	Family Nurse Practitioner	TATE-667N0	NC

General Provider Information

NPI Number	:	1245915271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDRA R TATE FNP

Provider Business Mailing Address
First Line	:	14310 PINTAIL LANDING LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-7422
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	537 W SUGAR CREEK RD STE 201
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-6103
Country	:	US
Telephone Number	:	704-979-8210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	01/13/2025

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Directions to “ CHANDRA R TATE FNP” Practice Location

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