Provider Demographics
NPI:1063948230
Name:HARTWICK, SAVANNAH IONE (PRSS)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:IONE
Last Name:HARTWICK
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CRESTVIEW DR.
Mailing Address - Street 2:
Mailing Address - City:HOLDENVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74848
Mailing Address - Country:US
Mailing Address - Phone:405-708-2450
Mailing Address - Fax:
Practice Address - Street 1:400 CRESTVIEW DR.
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848
Practice Address - Country:US
Practice Address - Phone:405-708-2450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant