Provider Demographics
NPI:1437409315
Name:SATTAZAHN, ERIN P (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:P
Last Name:SATTAZAHN
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 1:721 N SHIAWASSEE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1632
Mailing Address - Country:US
Mailing Address - Phone:989-729-1600
Mailing Address - Fax:989-729-4070
Practice Address - Street 1:721 N SHIAWASSEE ST STE 202
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1632
Practice Address - Country:US
Practice Address - Phone:989-729-1600
Practice Address - Fax:989-729-4070
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006457363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1437409315Medicaid