Provider Demographics
NPI:1083143598
Name:SAVAGE, STEPHANIE (CRNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6832 COOPERSTOWN CIR
Mailing Address - Street 2:
Mailing Address - City:COTTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35453-4347
Mailing Address - Country:US
Mailing Address - Phone:205-657-0544
Mailing Address - Fax:
Practice Address - Street 1:405 BELCHER ST
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:AL
Practice Address - Zip Code:35042-2946
Practice Address - Country:US
Practice Address - Phone:205-926-2992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF6170560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-141772OtherRN LICENSE