Individual
SATAVIA SIMONE GASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11530 PROVIDENCE RD, STE 1500, CHARLOTTE, NC 28277-2691
(704) 667-0760
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5014434
NC
Other
Enumeration date
05/27/2021
Last updated
07/15/2024
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