Provider Demographics
NPI:1104216357
Name:PATE, MARENA HOPE (RN, BSN)
Entity type:Individual
Prefix:
First Name:MARENA
Middle Name:HOPE
Last Name:PATE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:MARENA
Other - Middle Name:HOPE
Other - Last Name:HUNTING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:10 MARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25523-1058
Mailing Address - Country:US
Mailing Address - Phone:304-824-3033
Mailing Address - Fax:304-824-7947
Practice Address - Street 1:10 MARLAND AVE
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:WV
Practice Address - Zip Code:25523-1058
Practice Address - Country:US
Practice Address - Phone:304-824-3033
Practice Address - Fax:304-824-7947
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV52778163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool