Provider Demographics
NPI:1558981753
Name:BURCHETT, SAVANNAH GLYN (CRNP)
Entity Type:Individual
Prefix:MISS
First Name:SAVANNAH
Middle Name:GLYN
Last Name:BURCHETT
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 1:350 SPRINGVILLE STA
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35146-6163
Mailing Address - Country:US
Mailing Address - Phone:205-773-2075
Mailing Address - Fax:866-304-9633
Practice Address - Street 1:350 SPRINGVILLE STA
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:AL
Practice Address - Zip Code:35146-6163
Practice Address - Country:US
Practice Address - Phone:205-773-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-166386363LP0200X
AL1166386163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-166386OtherALABAMA LICENSE