Healthcare Provider Details

I. General information

NPI: 1912685546
Provider Name (Legal Business Name): SAVANNA PARKER DNP-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPICE LN
WINSTON SALEM NC
27103-5766
US

IV. Provider business mailing address

101 HOSPICE LN
WINSTON SALEM NC
27103-5766
US

V. Phone/Fax

Practice location:
  • Phone: 336-768-3972
  • Fax:
Mailing address:
  • Phone: 336-768-3972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2023086268
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number2023086268
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2023086268
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number2023086268
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: