Provider Demographics
NPI:1750354759
Name:SATTERWHITE, TERESA (NP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:SATTERWHITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-1225
Mailing Address - Fax:704-384-1226
Practice Address - Street 1:8310 UNIVERSITY EXEC PARK DR STE 550
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1572
Practice Address - Country:US
Practice Address - Phone:704-384-1225
Practice Address - Fax:704-384-1226
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC108244363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS79872Medicare UPIN
NC2593168BMedicare PIN
NC2593168BMedicare PIN