Provider Demographics
NPI:1487163515
Name:KAUFFMAN, SAVANNA R (PA-C)
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:R
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:R
Other - Last Name:STAUFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1167
Practice Address - Country:US
Practice Address - Phone:717-242-7480
Practice Address - Fax:717-242-7479
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059337363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant