Provider Demographics
NPI:1609153758
Name:SATRE, MARY JANE (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JANE
Last Name:SATRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARY JANE
Other - Middle Name:
Other - Last Name:LENHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:930 SE CARY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7419
Mailing Address - Country:US
Mailing Address - Phone:919-859-2566
Mailing Address - Fax:919-859-5252
Practice Address - Street 1:930 SE CARY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7419
Practice Address - Country:US
Practice Address - Phone:919-859-2566
Practice Address - Fax:919-859-5252
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008527363LF0000X
NY336910363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00372050Medicaid
NY00372050Medicaid