Provider Demographics
NPI:1215270442
Name:DEROSSETT, SAVANAH RENEE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SAVANAH
Middle Name:RENEE
Last Name:DEROSSETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 NIGHTFALL CIR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-5762
Mailing Address - Country:US
Mailing Address - Phone:931-248-4190
Mailing Address - Fax:
Practice Address - Street 1:7406 NIGHTFALL CIR
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-5762
Practice Address - Country:US
Practice Address - Phone:931-248-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-06
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212626183500000X
GARPH026927183500000X
TN376261835C0205X
ALP17167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835C0205XPharmacy Service ProvidersPharmacistCritical Care