MEDICARE: ISABELLA M SATTERTHWAIT PA-C

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	363A00000X	Physician Assistant	PA-1659	ID

General Provider Information

NPI Number	:	1437625662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABELLA M SATTERTHWAIT PA-C

Provider Business Mailing Address
First Line	:	3340 E GOLDSTONE DR
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-1026
Country	:	US
Telephone Number	:	208-367-5170
Fax Number	:

Provider Business Practice Location Address
First Line	:	3123 MEDICAL DR
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-6972
Country	:	US
Telephone Number	:	208-367-3131
Fax Number	:	208-367-4817

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

Provider Enumeration Date	:	10/15/2018
Last Update Date	:	01/25/2021

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