Provider Demographics
NPI:1215901939
Name:SATTERFIELD, MARY-ELIZABETH LOUISE (EDD,RNL)
Entity type:Individual
Prefix:DR
First Name:MARY-ELIZABETH
Middle Name:LOUISE
Last Name:SATTERFIELD
Suffix:
Gender:F
Credentials:EDD,RNL
Other - Prefix:DR
Other - First Name:MARY BETH
Other - Middle Name:
Other - Last Name:SATTERFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD,RN
Mailing Address - Street 1:3920 OLD LAKEPORT RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-9508
Mailing Address - Country:US
Mailing Address - Phone:712-276-5419
Mailing Address - Fax:
Practice Address - Street 1:3920 OLD LAKEPORT RD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-9508
Practice Address - Country:US
Practice Address - Phone:712-276-5419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA570103T00000X
IA288103T00000X
IA048039163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE42145965326Medicaid
IA0138667Medicaid
IA54117OtherWELLMARK BCBS
NE42145965326Medicaid
54117Medicare ID - Type Unspecified