Provider Demographics
NPI:1629816905
Name:EVANS, SAVANNA MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2587 TWIN MNR
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-4121
Mailing Address - Country:US
Mailing Address - Phone:334-507-9963
Mailing Address - Fax:
Practice Address - Street 1:2587 TWIN MNR
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-4121
Practice Address - Country:US
Practice Address - Phone:334-507-9963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-146704363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care