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General NPI Number Information
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NPI Number | 1235688284
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Entity Type | Individual
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Provider Name | SAVANNAH M FODERO
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Gender | Female
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Dates
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Enumeration Date | 09/30/2016
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 770 CENTRAL AVE
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City | DOVER
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State | NH
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Zip | 03820-3437
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Country | US
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Telephone | 603-742-0101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 412503
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City | BOSTON
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State | MA
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Zip | 02241-2503
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Country | US
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Telephone | 617-726-3884
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5008982
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 071399-23
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License Number State | NH
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