Provider Demographics
NPI:1306688700
Name:TATE, LAURA ANN (CRNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:TATE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:TATE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:900 BARTON RD
Mailing Address - Street 2:
Mailing Address - City:FRISCO CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36445-3405
Mailing Address - Country:US
Mailing Address - Phone:251-593-9204
Mailing Address - Fax:
Practice Address - Street 1:16 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-3036
Practice Address - Country:US
Practice Address - Phone:251-593-9204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-099647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily