Healthcare Provider Details

I. General information

NPI: 1871410324
Provider Name (Legal Business Name): KATHERINE MICHELLE TATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11544 GLENCREST DR NW
PICKERINGTON OH
43147-7545
US

IV. Provider business mailing address

2643 FLORIBUNDA DR
COLUMBUS OH
43209-3117
US

V. Phone/Fax

Practice location:
  • Phone: 614-937-5274
  • Fax:
Mailing address:
  • Phone: 614-937-5274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2573398
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: