Healthcare Provider Details

I. General information

NPI: 1295524700
Provider Name (Legal Business Name): SAVANNAH HOPE BROCK APRN, CNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAVANNAH HOPE BECKER

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 PARK DR
SAINT ROBERT MO
65584-7860
US

IV. Provider business mailing address

1800 COMMUNITY
CLINTON MO
64735-8804
US

V. Phone/Fax

Practice location:
  • Phone: 844-853-8937
  • Fax:
Mailing address:
  • Phone: 844-853-8937
  • Fax: 660-885-3690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025035027
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number517822
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2379664
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10026807
License Number StateOR
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number517822
License Number StateMO
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95229440
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041538582
License Number StateIL
# 8
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2525512
License Number StateMN
# 9
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number889270
License Number StateNY
# 10
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704398702
License Number StateMI
# 11
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2023019183
License Number StateMO
# 12
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN200005895
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: