Provider Demographics
NPI:1356922140
Name:SOPPET, SAVANNAH LYNN (MD)
Entity type:Individual
Prefix:MISS
First Name:SAVANNAH
Middle Name:LYNN
Last Name:SOPPET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:LYNN
Other - Last Name:SOPPET-RYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1523
Mailing Address - Street 2:
Mailing Address - City:BEECHER
Mailing Address - State:IL
Mailing Address - Zip Code:60401-1523
Mailing Address - Country:US
Mailing Address - Phone:708-663-9937
Mailing Address - Fax:
Practice Address - Street 1:1313 21ST AVENUE SOUTH
Practice Address - Street 2:703 OXFORD HOUSE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232
Practice Address - Country:US
Practice Address - Phone:615-936-0087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program