Provider Demographics
NPI:1609038090
Name:SATTLER, LISA ANN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANN
Last Name:SATTLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13609 CALIFORNIA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5260
Mailing Address - Country:US
Mailing Address - Phone:180-045-6565
Mailing Address - Fax:
Practice Address - Street 1:16 FUSTING AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-4413
Practice Address - Country:US
Practice Address - Phone:410-747-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05281172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker