Provider Demographics
NPI:1568573475
Name:SAVAN, TERRY SUE (CNP)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:SUE
Last Name:SAVAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12200 ACADEMY RD NE
Mailing Address - Street 2:1228
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7245
Mailing Address - Country:US
Mailing Address - Phone:314-610-1536
Mailing Address - Fax:505-298-2425
Practice Address - Street 1:5901 HARPER DR NE
Practice Address - Street 2:PRESBYTERIAN URGENT CARE NORTHSIDE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3587
Practice Address - Country:US
Practice Address - Phone:505-823-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA-003143-L363A00000X
PATP006242B363LF0000X
CA287073-8100363LF0000X
MO070035363LF0000X
CA13745363A00000X
NMCNP-02454363LF0000X
NM81467163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMS84483Medicare UPIN
NM124913Medicare Oscar/Certification