Provider Demographics
NPI:1780112227
Name:PATE, ERIN NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:PATE
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 1:804 E 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-1514
Mailing Address - Country:US
Mailing Address - Phone:229-273-8881
Mailing Address - Fax:
Practice Address - Street 1:510 ALSTON ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:GA
Practice Address - Zip Code:31825-6012
Practice Address - Country:US
Practice Address - Phone:229-887-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-29
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN216671363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily