Provider Demographics
NPI: | 1851954234 |
---|---|
Name: | HAYES, SAVANNAH SAVITT (WHNP) |
Entity type: | Individual |
Prefix: | MS |
First Name: | SAVANNAH |
Middle Name: | SAVITT |
Last Name: | HAYES |
Suffix: | |
Gender: | F |
Credentials: | WHNP |
Other - Prefix: | |
Other - First Name: | SAVANNAH |
Other - Middle Name: | LEIGH |
Other - Last Name: | SAVITT |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | |
Mailing Address - Street 1: | 10050 KENNERLY RD STE 1500 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAINT LOUIS |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63128-2198 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 314-525-1545 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 10050 KENNERLY RD STE 1500 |
Practice Address - Street 2: | |
Practice Address - City: | SAINT LOUIS |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63128-2198 |
Practice Address - Country: | US |
Practice Address - Phone: | 314-525-1545 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2019-04-21 |
Last Update Date: | 2024-12-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | 2020022387 | 363LW0102X |
GA | RN232897 | 163W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LW0102X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No | 163W00000X | Nursing Service Providers | Registered Nurse |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MO | 420129522 | Medicaid |