Provider Demographics
NPI:1225582083
Name:JANSSEN, SAVANNA NICOLE (DC)
Entity type:Individual
Prefix:MRS
First Name:SAVANNA
Middle Name:NICOLE
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:NICOLE
Other - Last Name:THORNTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:2381 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IA
Mailing Address - Zip Code:50833-8208
Mailing Address - Country:US
Mailing Address - Phone:712-621-6519
Mailing Address - Fax:
Practice Address - Street 1:409 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IA
Practice Address - Zip Code:50833
Practice Address - Country:US
Practice Address - Phone:712-621-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
IA0878832255A2300X
IA106659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer