Provider Demographics
NPI:1407394919
Name:SAMIEC, SAVANNAH (FNP-C)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:SAMIEC
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:9328 E RAINTREE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2098
Mailing Address - Country:US
Mailing Address - Phone:602-266-8463
Mailing Address - Fax:
Practice Address - Street 1:9328 E RAINTREE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2098
Practice Address - Country:US
Practice Address - Phone:602-266-8463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9875363LA2200X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health