Provider Demographics
NPI:1457994535
Name:THOMPSON, SAVANNAH MICHELLE
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MICHELLE
Last Name:THOMPSON
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 1:10301 RENFREW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137-3926
Mailing Address - Country:US
Mailing Address - Phone:314-327-8859
Mailing Address - Fax:
Practice Address - Street 1:10301 RENFREW DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63137-3926
Practice Address - Country:US
Practice Address - Phone:314-327-8859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider