Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 1-106258 | AL |
NPI | 1003100694 |
---|---|
Provider Name | Ms. Sarah Oliver Pate |
First Address | Tuscaloosa, AL 35405-8784 |
Second Address | Tuscaloosa, AL 35401-5235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2011 |
Last Update Date | 23/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-106258 | RN (01) | AL |