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General NPI Number Information
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NPI Number | 1285937466
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Entity Type | Individual
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Provider Name | JANELLE LOUISE TATE NP
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Gender | Female
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Dates
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Enumeration Date | 12/10/2010
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 9930 KINCEY AVE STE 360
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-6541
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Country | US
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Telephone | 704-316-4830
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Fax |
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Provider Business Mailing Address
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Address Line | 1413 RAND CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6461
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Country | US
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Telephone | 757-282-3816
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024140083
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5023274
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License Number State | NC
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