Provider Demographics
NPI:1942937057
Name:SAVAGE, CHRISTY D
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:D
Last Name:SAVAGE
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 1:1400 HAL GREER BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-4114
Mailing Address - Country:US
Mailing Address - Phone:304-399-6610
Mailing Address - Fax:304-399-6621
Practice Address - Street 1:1400 HAL GREER BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-4114
Practice Address - Country:US
Practice Address - Phone:304-399-6572
Practice Address - Fax:304-699-6571
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV112650363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV005021229OtherHIGHMARK
WVWVD498AOtherMEDICARE
WV1942937057Medicaid
KY7100840640Medicaid