Healthcare Provider Details

I. General information

NPI: 1952942963
Provider Name (Legal Business Name): SHANE SATTERFIELD AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PINE ST
ABILENE TX
79601-2432
US

IV. Provider business mailing address

PO BOX 641057
PITTSBURGH PA
15264-1057
US

V. Phone/Fax

Practice location:
  • Phone: 325-670-2753
  • Fax:
Mailing address:
  • Phone: 800-655-2656
  • Fax: 412-822-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number829977
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: