Healthcare Provider Details

I. General information

NPI: 1174846760
Provider Name (Legal Business Name): CHRISTINA P PATE MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTY PATE PT

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 11/07/2021
Certification Date: 11/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 BLACKBURN RD
APEX NC
27502-5232
US

IV. Provider business mailing address

1103 BLACKBURN RD
APEX NC
27502-5232
US

V. Phone/Fax

Practice location:
  • Phone: 919-274-8948
  • Fax:
Mailing address:
  • Phone: 919-274-8948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberP5525
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: