SANDRA TATE APN NPI 1326093493

NPI Information

NPI: 1326093493
Provider Name: SANDRA TATE, APN
Classification: Clinical Nurse Specialist - 364SP0807X
Entity Type: Individual

Specialization: Psychiatric/Mental Health, Child & Adolescent

PECOS Registration: Yes

Address:
3412 OFFICE PARK DR
MARION, IL
ZIP 62959
Phone: (618) 292-9999
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Sandra Tate, APN is a psychiatric/mental health and child and adolescent clinical nurse specialist in Marion, IL with 24 years of experience. Sandra Tate, APN NPI is 1326093493. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3412 OFFICE PARK DR
MARION, IL
ZIP 62959-477
Phone: (618) 292-9999
Fax: (618) 551-2757

The NPI 1326093493 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/24/2006 and was last updated on 5/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	209005279	ILLINOIS	No
2	364SP0808X	Clinical Nurse Specialist	Psychiatric/Mental Health	041290556	ILLINOIS	No
3	364SP0808X	Clinical Nurse Specialist	Psychiatric/Mental Health	277000849	ILLINOIS	No
4	364SP0807X	Clinical Nurse Specialist	Psychiatric/Mental Health, Child & Adolescent	277000849	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CG2264	OTHER	ILLINOIS	RR GROUP NUMBER
2	207988	OTHER	ILLINOIS	GROUP
3	P00220754	OTHER	ILLINOIS	RR MEDICARE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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