1578918637 NPI number — MRS. MICHELLE RHEA SATTERLY ARNP

Table of content: MRS. MICHELLE RHEA SATTERLY ARNP (NPI 1578918637)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578918637 NPI number — MRS. MICHELLE RHEA SATTERLY ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SATTERLY
Provider First Name:
MICHELLE
Provider Middle Name:
RHEA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUTCHCROFT
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
RHEA
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1578918637
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/25/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2560 24TH STREET
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
ROCK ISLAND
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
309-779-4150
Provider Business Mailing Address Fax Number:
309-779-4155

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2560 24TH STREET
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
ROCK ISLAND
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
309-779-4150
Provider Business Practice Location Address Fax Number:
309-779-4155
Provider Enumeration Date:
04/26/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  209.016313 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: 127858 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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