Provider Demographics
NPI:1184461832
Name:SATTERWHITE, PAUL JEFFERSON JR (RN)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JEFFERSON
Last Name:SATTERWHITE
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 ENNISWORTH LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-4148
Mailing Address - Country:US
Mailing Address - Phone:864-248-3882
Mailing Address - Fax:
Practice Address - Street 1:10926 DAVID TAYLOR DR STE 120
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-0039
Practice Address - Country:US
Practice Address - Phone:864-248-3882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC366982163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse