Healthcare Provider Details

I. General information

NPI: 1912706185
Provider Name (Legal Business Name): SAVANNAH RENEE HARTMAN CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1429 COUGAR WAY
NEW MARKET TN
37820-0355
US

IV. Provider business mailing address

PO BOX 355
NEW MARKET TN
37820-0355
US

V. Phone/Fax

Practice location:
  • Phone: 865-601-4644
  • Fax: 423-370-1799
Mailing address:
  • Phone: 865-601-4644
  • Fax: 423-370-1799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number158
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: