Healthcare Provider Details

I. General information

NPI: 1144970583
Provider Name (Legal Business Name): DINA LYNNE SATTENSPIEL APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

840 HARRISON AVE
BOSTON MA
02118-2905
US

V. Phone/Fax

Practice location:
  • Phone: 617-643-8281
  • Fax:
Mailing address:
  • Phone: 617-414-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2364452
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: