Healthcare Provider Details

I. General information

NPI: 1225952971
Provider Name (Legal Business Name): SAVANNA HORSLEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 S PIERCE ST STE 102
EDEN NC
27288-5863
US

IV. Provider business mailing address

63 BRANDYWINE CT
RIDGEWAY VA
24148-3022
US

V. Phone/Fax

Practice location:
  • Phone: 336-627-5178
  • Fax:
Mailing address:
  • Phone: 336-627-5178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5025140
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: