Provider Demographics
NPI:1093175994
Name:TADIN, SAVANNAH MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MARIE
Last Name:TADIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4831 OCANA PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-2444
Mailing Address - Country:US
Mailing Address - Phone:740-243-7077
Mailing Address - Fax:
Practice Address - Street 1:8851 CENTER DR STE 505
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3059
Practice Address - Country:US
Practice Address - Phone:858-810-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH142773363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology