Provider Demographics
NPI:1396203576
Name:FLANNERY, SAVANNAH C
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:C
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8299 SUN FLARE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-4024
Mailing Address - Country:US
Mailing Address - Phone:330-367-7183
Mailing Address - Fax:
Practice Address - Street 1:774 INTERNET DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-2589
Practice Address - Country:US
Practice Address - Phone:614-443-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator