Provider Demographics
NPI:1467006106
Name:SAVAGE, SHENELLE (CNA)
Entity Type:Individual
Prefix:
First Name:SHENELLE
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 CREEKVIEW LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:MS
Mailing Address - Zip Code:39069-4596
Mailing Address - Country:US
Mailing Address - Phone:601-446-2067
Mailing Address - Fax:
Practice Address - Street 1:131 CREEKVIEW LN
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:MS
Practice Address - Zip Code:39069-4596
Practice Address - Country:US
Practice Address - Phone:601-446-2067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant