Provider Demographics
NPI:1306307731
Name:SATIZABAL, SHELLY LYNN (PA)
Entity type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:LYNN
Last Name:SATIZABAL
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3101 COOPERS ARCH
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-3457
Mailing Address - Country:US
Mailing Address - Phone:619-300-0166
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2022-06-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical