Provider Demographics
NPI:1962005819
Name:KETTERER, SAVANNAH D (PA-C)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:D
Last Name:KETTERER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:
Practice Address - Street 1:1525 HUNT CLUB BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6070
Practice Address - Country:US
Practice Address - Phone:615-822-2177
Practice Address - Fax:615-822-0300
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2024-07-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant