Provider Demographics
NPI:1407456510
Name:RIFFE, SAVANNAH (RN)
Entity Type:Individual
Prefix:MRS
First Name:SAVANNAH
Middle Name:
Last Name:RIFFE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:SAVANNAH
Other - Middle Name:
Other - Last Name:JORGENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:322 CHIMNEY ROCK DR APT 202
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-4186
Mailing Address - Country:US
Mailing Address - Phone:469-363-6371
Mailing Address - Fax:
Practice Address - Street 1:322 CHIMNEY ROCK DR APT 202
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-4186
Practice Address - Country:US
Practice Address - Phone:469-363-6371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX960890163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse