Provider Demographics
NPI:1376564260
Name:SAATHOFF, BECKY MARLENE (PA)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:MARLENE
Last Name:SAATHOFF
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5200 S 56TH ST
Mailing Address - Street 2:STE 2
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1884
Mailing Address - Country:US
Mailing Address - Phone:402-421-6200
Mailing Address - Fax:402-421-6070
Practice Address - Street 1:3901 PINE LAKE RD
Practice Address - Street 2:SUITE 211
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5497
Practice Address - Country:US
Practice Address - Phone:402-423-4200
Practice Address - Fax:402-423-4201
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2018-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE1266363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE38820OtherBCBS
KSP99006Medicare UPIN
NEP00332497Medicare PIN
NE280353Medicare PIN