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General NPI Number Information
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NPI Number | 1912981143
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Entity Type | Individual
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Provider Name | KATRINA DENISE SCANNELLI PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 42 CHAUCER ST
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City | SAVANNAH
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State | GA
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Zip | 31410-3824
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Country | US
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Telephone | 912-429-3749
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 E VICTORY DRIVE SUITE E #1059
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City | SAVANNAH
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State | GA
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Zip | 31404
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Country | US
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Telephone | 912-429-3749
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3469
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA064316
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA3712
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License Number State | MA
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