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NPI Code Detail

MEDICARE: MS. CASSANDRA TATE RN

MEDICARE: MS. CASSANDRA TATE 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
1163W00000XRegistered NurseRN.193622OH
2163WC0200XCritical Care Medicine Registered NurseRN.193622OH
3163WG0600XGerontology Registered NurseRN.193622OH
4163WM0705XMedical-Surgical Registered NurseRN.193622OH

General Provider Information

NPI Number : 1982981965
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CASSANDRA TATE RN
Provider Business Mailing Address
First Line : 3301 KILDARE RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-2932
Country : US
Telephone Number : 216-397-1201
Fax Number : 216-927-3746
Provider Business Practice Location Address
First Line : 3301 KILDARE RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-2932
Country : US
Telephone Number : 216-397-1201
Fax Number : 216-927-3746
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2011
Last Update Date : 11/04/2011

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