Provider Demographics
NPI:1871212852
Name:TATE, CHRISTINA D'LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:D'LYNN
Last Name:TATE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6049 FM 1902
Mailing Address - Street 2:
Mailing Address - City:JOSHUA
Mailing Address - State:TX
Mailing Address - Zip Code:76058-4593
Mailing Address - Country:US
Mailing Address - Phone:985-249-8250
Mailing Address - Fax:
Practice Address - Street 1:6049 FM 1902
Practice Address - Street 2:
Practice Address - City:JOSHUA
Practice Address - State:TX
Practice Address - Zip Code:76058-4593
Practice Address - Country:US
Practice Address - Phone:985-249-8250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1090724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty