Provider Demographics
NPI:1962917963
Name:SATTERLY, JAMIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:SATTERLY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-6969
Mailing Address - Country:US
Mailing Address - Phone:402-750-6169
Mailing Address - Fax:
Practice Address - Street 1:2400 W PASEWALK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4608
Practice Address - Country:US
Practice Address - Phone:402-371-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE137251835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE13725OtherSTATE ID