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NPI Code Detail

MEDICARE: MS. GRETEL ERICA PATE RN

MEDICARE: MS. GRETEL ERICA PATE RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse602847CA

General Provider Information

NPI Number : 1447410774
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GRETEL ERICA PATE RN
Provider Business Mailing Address
First Line : 12500 BRUCEVILLE RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-9784
Country : US
Telephone Number : 916-874-5222
Fax Number : 916-874-8183
Provider Business Practice Location Address
First Line : 12500 BRUCEVILLE RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-9784
Country : US
Telephone Number : 916-874-5222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2008
Last Update Date : 10/02/2008

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Directions to “ MS. GRETEL ERICA PATE RN” Practice Location

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