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General NPI Number Information
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NPI Number | 1912034877
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Entity Type | Individual
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Provider Name | MIRIAM CHRISTINE SATA MSN RN AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 35 W HURON ST
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City | PONTIAC
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State | MI
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Zip | 48342-2120
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Country | US
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Telephone | 248-335-0632
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Fax |
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Provider Business Mailing Address
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Address Line | 2060 BARBERRY DR
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-1179
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Country | US
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Telephone | 248-318-1175
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4704127925
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 4704127925
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 4704127925
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License Number State | MI
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