Provider Demographics
NPI:1467123745
Name:MILLER, SAVANNAH LEIGH
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LEIGH
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:814-373-2923
Mailing Address - Fax:
Practice Address - Street 1:765 LIBERTY ST STE 309
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2567
Practice Address - Country:US
Practice Address - Phone:814-333-3945
Practice Address - Fax:814-333-3947
Is Sole Proprietor?:No
Enumeration Date:2021-09-25
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024411363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner