Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704213511 | MI |
NPI | 1003161357 |
---|---|
Provider Name | Karen Satawa |
First Address | Livonia, MI 48154-5085 |
Second Address | Livonia, MI 48154-5085 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2012 |
Last Update Date | 23/07/2012 |