Provider Demographics
NPI:1093510745
Name:WILTFANG, SAVANNAH MEREDITH (DNAP, CRNA)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MEREDITH
Last Name:WILTFANG
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Gender:
Credentials:DNAP, CRNA
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Mailing Address - Street 1:PO BOX 2758
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50704-2758
Mailing Address - Country:US
Mailing Address - Phone:319-235-5390
Mailing Address - Fax:
Practice Address - Street 1:1015 S HACKETT RD STE B
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-3543
Practice Address - Country:US
Practice Address - Phone:319-234-5990
Practice Address - Fax:319-234-5994
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAD183494367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered