MEDICARE: JESSICA SATHRE APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	182349	CO
2	363LF0000X	Family Nurse Practitioner	292945	AZ
3	363LF0000X	Family Nurse Practitioner	995260	CO

General Provider Information

NPI Number	:	1124322292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SATHRE APN

Provider Business Mailing Address
First Line	:	5601 W EUGIE AVE STE 211
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85304-1258
Country	:	US
Telephone Number	:	480-856-0268
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 W EUGIE AVE STE 211
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85304-1258
Country	:	US
Telephone Number	:	480-856-0268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2011
Last Update Date	:	02/05/2024

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Directions to “ JESSICA SATHRE APN” Practice Location

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