Healthcare Provider Details

I. General information

NPI: 1134988934
Provider Name (Legal Business Name): SAVANNAH CHARLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 W EXCHANGE ST
AKRON OH
44302-1711
US

IV. Provider business mailing address

PO BOX 933428
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 800-230-7526
  • Fax: 720-738-8684
Mailing address:
  • Phone: 800-230-7526
  • Fax: 720-738-8684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.0036992
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number518723
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: