MEDICARE: KELLI SATTERFIELD NP

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	363LF0000X	Family Nurse Practitioner	32212	TN

General Provider Information

NPI Number	:	1770206716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI SATTERFIELD NP

Provider Business Mailing Address
First Line	:	502 ELLINGTON DR
Second Line	:
City	:	LAFAYETTE
State	:	TN
Zip	:	37083-1697
Country	:	US
Telephone Number	:	615-561-1042
Fax Number	:	615-561-1043

Provider Business Practice Location Address
First Line	:	502 ELLINGTON DR
Second Line	:
City	:	LAFAYETTE
State	:	TN
Zip	:	37083-1697
Country	:	US
Telephone Number	:	615-561-1042
Fax Number	:	615-561-1043

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

Provider Enumeration Date	:	09/23/2022
Last Update Date	:	09/23/2022

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