Healthcare Provider Details

I. General information

NPI: 1447939269
Provider Name (Legal Business Name): SAVANNAH PATE COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S ALSTON ST
FOLEY AL
36535-1914
US

IV. Provider business mailing address

30000 TOWN CENTER AVE APT 1030
SPANISH FORT AL
36527-9448
US

V. Phone/Fax

Practice location:
  • Phone: 850-633-4877
  • Fax:
Mailing address:
  • Phone: 205-253-1929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: