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General NPI Number Information
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NPI Number | 1992128383
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Entity Type | Individual
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Provider Name | SAVANNAH MALLORY WILHITE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 1695 MAIN STREET SUITE 400
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City | SPRINGFIELD
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State | MA
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Zip | 01103
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Country | US
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Telephone | 413-739-5572
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Fax |
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Provider Business Mailing Address
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Address Line | 10123 SE MARKET ST
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City | PORTLAND
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State | OR
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Zip | 97216-2599
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Country | US
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Telephone | 503-257-2500
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1-143128
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2324823
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 201507674NP-PP
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License Number State | OR
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