Healthcare Provider Details

I. General information

NPI: 1275975542
Provider Name (Legal Business Name): DORIS ALLEN TATE CRNP, BC-ADM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DORIS ANNE ALLEN RN

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 S TALBOT ST STE 9
ST MICHAELS MD
21663-2606
US

IV. Provider business mailing address

1110 S TALBOT ST STE 9
ST MICHAELS MD
21663-2606
US

V. Phone/Fax

Practice location:
  • Phone: 410-490-6214
  • Fax: 800-405-1473
Mailing address:
  • Phone: 410-490-6214
  • Fax: 800-405-1473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR172337
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: