Provider Demographics
NPI:1811197098
Name:SATHRE, KAREN ELAINE
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELAINE
Last Name:SATHRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3368 BUNKER LAKE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-3787
Mailing Address - Country:US
Mailing Address - Phone:612-308-2848
Mailing Address - Fax:
Practice Address - Street 1:3368 BUNKER LAKE BLVD NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-3787
Practice Address - Country:US
Practice Address - Phone:612-308-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNNOT APPLICABLEOtherCAR INSURANCE ONLY