Provider Demographics
NPI:1568088128
Name:VINSON, SAVANNAH ELIZABETH
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:ELIZABETH
Last Name:VINSON
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 1:8049 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:QUINLAN
Mailing Address - State:TX
Mailing Address - Zip Code:75474-9169
Mailing Address - Country:US
Mailing Address - Phone:903-272-2455
Mailing Address - Fax:
Practice Address - Street 1:4215 JOE RAMSEY BLVD E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7852
Practice Address - Country:US
Practice Address - Phone:903-408-1288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX881243163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse