MEDICARE: KAREN ELAINE SATHRE

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	174400000X	Specialist		MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NOT APPLICABLE	OTHER	MN	CAR INSURANCE ONLY

General Provider Information

NPI Number	:	1811197098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ELAINE SATHRE

Provider Business Mailing Address
First Line	:	3368 BUNKER LAKE BLVD NW
Second Line	:
City	:	ANDOVER
State	:	MN
Zip	:	55304-3787
Country	:	US
Telephone Number	:	612-308-2848
Fax Number	:

Provider Business Practice Location Address
First Line	:	3368 BUNKER LAKE BLVD NW
Second Line	:
City	:	ANDOVER
State	:	MN
Zip	:	55304-3787
Country	:	US
Telephone Number	:	612-308-2848
Fax Number	:

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

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	07/25/2007

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