Provider Demographics
NPI:1174216097
Name:NOWAK-SATTERWHITE, ESSENCE
Entity type:Individual
Prefix:
First Name:ESSENCE
Middle Name:
Last Name:NOWAK-SATTERWHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28657 N DOLOMITE LN
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-6053
Mailing Address - Country:US
Mailing Address - Phone:520-280-9038
Mailing Address - Fax:
Practice Address - Street 1:28657 N DOLOMITE LN
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-6053
Practice Address - Country:US
Practice Address - Phone:520-280-9038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ132700000X, 171M00000X, 172V00000X, 374U00000X
AZD07601447172A00000X
AZT073664183700000X
AZ281464376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver
No172V00000XOther Service ProvidersCommunity Health Worker
No183700000XPharmacy Service ProvidersPharmacy Technician
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA024804775Medicaid