MEDICARE: CLIFTON SATTERFIELD NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	2018025398	MO

General Provider Information

NPI Number	:	1679050736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFTON SATTERFIELD NP

Provider Business Mailing Address
First Line	:	1006 E SKYLINE AVE
Second Line	:
City	:	OZARK
State	:	MO
Zip	:	65721-7809
Country	:	US
Telephone Number	:	573-263-8303
Fax Number	:

Provider Business Practice Location Address
First Line	:	1006 E SKYLINE AVE
Second Line	:
City	:	OZARK
State	:	MO
Zip	:	65721-7809
Country	:	US
Telephone Number	:	573-263-8303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2018
Last Update Date	:	07/22/2018

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