Provider Demographics
NPI:1407537350
Name:SHEPARD, SAVANAH (CRNP)
Entity Type:Individual
Prefix:
First Name:SAVANAH
Middle Name:
Last Name:SHEPARD
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 1:812 REGAL DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5603
Mailing Address - Country:US
Mailing Address - Phone:256-964-8177
Mailing Address - Fax:256-934-2422
Practice Address - Street 1:812 REGAL DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5603
Practice Address - Country:US
Practice Address - Phone:256-964-8177
Practice Address - Fax:256-934-2422
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-169500363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner