Provider Demographics
NPI:1124719380
Name:SIEWE, SAVINIEN (PMHNP - BC)
Entity type:Individual
Prefix:MR
First Name:SAVINIEN
Middle Name:
Last Name:SIEWE
Suffix:
Gender:
Credentials:PMHNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21873 WOODCOCK WAY
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-9527
Mailing Address - Country:US
Mailing Address - Phone:301-404-1751
Mailing Address - Fax:
Practice Address - Street 1:809 S W S YOUNG DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-4801
Practice Address - Country:US
Practice Address - Phone:254-226-3090
Practice Address - Fax:888-595-2540
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR1932992084P0800X
KS82731363LP0808X
TX1194536363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry