Provider Demographics
NPI:1194587162
Name:LAURENDINE, SAVANNAH JOI
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:JOI
Last Name:LAURENDINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 LEE ROAD 137 LOT 101
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-7504
Mailing Address - Country:US
Mailing Address - Phone:251-600-9013
Mailing Address - Fax:
Practice Address - Street 1:2038 LEE ROAD 137 LOT 101
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-7504
Practice Address - Country:US
Practice Address - Phone:251-600-9013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program