Provider Demographics
NPI:1386363182
Name:SMOLA, SAVANNA KAY-ELLA (CNM)
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:KAY-ELLA
Last Name:SMOLA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:5153 N 9TH AVE STE 307
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5719
Practice Address - Country:US
Practice Address - Phone:850-416-6384
Practice Address - Fax:850-416-6394
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028739367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife