Provider Demographics
NPI:1003180555
Name:SATERENZOLLER, ELIZABETH K (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:K
Last Name:SATERENZOLLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 8673
Mailing Address - Street 2:1015 MARSH STREET
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8673
Mailing Address - Country:US
Mailing Address - Phone:507-385-4700
Mailing Address - Fax:
Practice Address - Street 1:1015 MARSH STREET
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56002-8673
Practice Address - Country:US
Practice Address - Phone:507-385-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1682363AS0400X
WI4312363A00000X
WI4312-23363AS0400X
MN11079363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical