Healthcare Provider Details
I. General information
NPI: 1447238514
Provider Name (Legal Business Name): NICHOLE BATEMAN SATTERWHITE PA-C, MPAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/09/2006
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
310 2ND AVE SW STE 104
MIAMI OK
74354-6708
US
IV. Provider business mailing address
5300 N INDEPENDENCE AVE 280
OKLAHOMA CITY OK
73112-5556
US
V. Phone/Fax
- Phone: 918-540-7867
- Fax: 918-540-7875
- Phone: 918-540-7867
- Fax: 918-540-7875
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA851 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: