Provider Demographics
NPI:1649008780
Name:SINKE, SAVANNAH ROSE (AGNP-BC)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:ROSE
Last Name:SINKE
Suffix:
Gender:F
Credentials:AGNP-BC
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:ROSE
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1773 MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3075 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2773
Practice Address - Country:US
Practice Address - Phone:858-939-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030441363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner