Healthcare Provider Details

I. General information

NPI: 1396662706
Provider Name (Legal Business Name): SAVANNAH FAITH STUMP RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34890 W HWY #B507
MANNFORD OK
74044
US

IV. Provider business mailing address

34890 W HWY #B507
MANNFORD OK
74044
US

V. Phone/Fax

Practice location:
  • Phone: 417-312-0398
  • Fax: 417-312-0398
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number213523
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: