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General NPI Number Information
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NPI Number | 1518779842
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Entity Type | Individual
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Provider Name | SAVANNAH NICOLE STILTNER
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Gender | Female
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 18765 RIVERSIDE DR, VANSANT, VA 24656
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City | VANSANT
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State | VA
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Zip | 24656
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Country | US
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Telephone | 276-935-2880
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19
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City | MAXIE
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State | VA
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Zip | 24628-0019
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Country | US
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Telephone | 276-701-6861
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001302989
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License Number State | VA
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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 | 0024192630
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License Number State | VA
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