Provider Demographics
NPI:1760378632
Name:FRUEAN, SAVANNAH J
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:J
Last Name:FRUEAN
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 1:351 W PARKS HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-6953
Mailing Address - Country:US
Mailing Address - Phone:907-563-1000
Mailing Address - Fax:907-563-2045
Practice Address - Street 1:351 W PARKS HWY STE 200
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-6953
Practice Address - Country:US
Practice Address - Phone:907-563-1000
Practice Address - Fax:907-563-2045
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist