Healthcare Provider Details

I. General information

NPI: 1679237564
Provider Name (Legal Business Name): SAVANNAH KLEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 S VAL VISTA DR STE 115
GILBERT AZ
85295-1676
US

IV. Provider business mailing address

2579 W STRADLING AVE
APACHE JUNCTION AZ
85120-0263
US

V. Phone/Fax

Practice location:
  • Phone: 480-931-3053
  • Fax:
Mailing address:
  • Phone: 941-929-6831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number260700
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: