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General NPI Number Information
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NPI Number | 1992341796
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Entity Type | Individual
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Provider Name | SATCHEL JAMES ITEN APRN, CNP
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Gender | Male
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Dates
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Enumeration Date | 11/27/2019
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 1900 CENTRACARE CIR STE 500
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City | SAINT CLOUD
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State | MN
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Zip | 56303-5000
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Country | US
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Telephone | 320-229-5099
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Fax |
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Provider Business Mailing Address
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Address Line | 1137 ORCHID DR NE
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City | SAUK RAPIDS
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State | MN
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Zip | 56379-4404
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Country | US
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Telephone | 320-291-3653
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 7049
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License Number State | MN
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