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General NPI Number Information
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NPI Number | 1518190404
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Entity Type | Individual
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Provider Name | SAVANNAH A KAISS CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 10320 LITTLE PATUXENT PKWY STE 101
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City | COLUMBIA
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State | MD
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Zip | 21044-3342
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Country | US
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Telephone | 410-884-9599
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Fax |
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Provider Business Mailing Address
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Address Line | 5939 GALES LN
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City | COLUMBIA
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State | MD
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Zip | 21045-3839
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Country | US
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Telephone | 410-715-5190
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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 | R177602
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License Number State | MD
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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 | SP010424
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License Number State | PA
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