Tate Coltan Staker, PA-C
NPI #1184253585 in Rexburg, Idaho
Provider Information
- NPI Number
- 1184253585
- Entity Type
- Individual
- Name
- Tate Coltan Staker, PA-C
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Apr 7, 2020
- Last Updated
- Oct 28, 2021
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Physician Assistant |
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