Provider Demographics
NPI:1639897614
Name:DUNCAN, SAVANNAH JEAN (RPHT)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:JEAN
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:RPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BEAR DR STE 4
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65793-7103
Mailing Address - Country:US
Mailing Address - Phone:417-469-9009
Mailing Address - Fax:417-469-5005
Practice Address - Street 1:110 BEAR DR STE 4
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65793-7103
Practice Address - Country:US
Practice Address - Phone:417-469-9009
Practice Address - Fax:417-469-5005
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021010572183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician