Healthcare Provider Details

I. General information

NPI: 1285504845
Provider Name (Legal Business Name): SATYA SUBEDI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 BOGUE ST
EAST LANSING MI
48824-6207
US

IV. Provider business mailing address

1878 CRICKET LN
EAST LANSING MI
48823-1225
US

V. Phone/Fax

Practice location:
  • Phone: 800-605-6424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704241804
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: