Provider Demographics
NPI:1609468271
Name:ADRIAN, SAVANNAH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SAVANNAH
Middle Name:
Last Name:ADRIAN
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 1:1435 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-2652
Mailing Address - Country:US
Mailing Address - Phone:502-541-8773
Mailing Address - Fax:
Practice Address - Street 1:6420 ROCKLEDGE DR STE 4100
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7847
Practice Address - Country:US
Practice Address - Phone:240-762-5130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR243228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily