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General NPI Number Information
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NPI Number | 1710509013
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Entity Type | Individual
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Provider Name | KATHERINE MARIE PATE MPAS
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Gender | Female
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 1031 BELLEVUE AVE STE 280A
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1818
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Country | US
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Telephone | 314-977-1050
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Fax | 559-459-3720
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Provider Business Mailing Address
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Address Line | 1031 BELLEVUE AVE STE 280A
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1818
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Country | US
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Telephone | 314-977-1050
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Fax | 559-443-2681
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 58282
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License Number State | CA
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