Provider Demographics
NPI:1427361914
Name:SCOGGINS, SAVANNAH SMITH (CNM)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:SMITH
Last Name:SCOGGINS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 SILVER HILL RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30747-5454
Mailing Address - Country:US
Mailing Address - Phone:706-857-7808
Mailing Address - Fax:
Practice Address - Street 1:1608 MARTHA BERRY BLVD NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1622
Practice Address - Country:US
Practice Address - Phone:706-234-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN175735367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife