Provider Demographics
NPI:1174695969
Name:SATTERFIELD, LILLIAN KAY (PN060590)
Entity type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:KAY
Last Name:SATTERFIELD
Suffix:
Gender:F
Credentials:PN060590
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 TOLEDO AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-1430
Mailing Address - Country:US
Mailing Address - Phone:440-246-2270
Mailing Address - Fax:440-246-0185
Practice Address - Street 1:3134 TOLEDO AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1430
Practice Address - Country:US
Practice Address - Phone:440-246-2270
Practice Address - Fax:440-246-0185
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-060590164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2550967OtherINDEPENDENT PROVIDER