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NPI Code Detail

MEDICARE: SAVANNAH SANDVICK PA-C

MEDICARE: SAVANNAH SANDVICK PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant121326IA

General Provider Information

NPI Number : 1255073813
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH SANDVICK PA-C
Provider Business Mailing Address
First Line : 1209 BLUEGRASS CIR UNIT 12
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-8098
Country : US
Telephone Number : 970-342-6052
Fax Number :
Provider Business Practice Location Address
First Line : 2710 SAINT FRANCIS DR STE 104
Second Line :
City : WATERLOO
State : IA
Zip : 50702-5633
Country : US
Telephone Number : 319-272-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2022
Last Update Date : 08/16/2023

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Directions to “ SAVANNAH SANDVICK PA-C” Practice Location

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