Provider Demographics
NPI:1487667218
Name:SAUTER, PATRICIA K (ACNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:K
Last Name:SAUTER
Suffix:
Gender:F
Credentials:ACNP
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 60516
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0516
Mailing Address - Country:US
Mailing Address - Phone:336-277-4050
Mailing Address - Fax:336-277-4070
Practice Address - Street 1:2825 LYNDHURST AVE
Practice Address - Street 2:STE 101
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4146
Practice Address - Country:US
Practice Address - Phone:336-277-4050
Practice Address - Fax:336-277-4070
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006197363LA2100X, 363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1487667218Medicaid
SCNP2434Medicaid
NC1487667218Medicaid