MEDICARE: MS. FREDA CECELIA SAVAHL

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
1	364SW0102X	Women's Health Clinical Nurse Specialist	APRN-365	HI
2	363LW0102X	Women's Health Nurse Practitioner	449655	TX
3	363L00000X	Nurse Practitioner	AP104182	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528243524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FREDA CECELIA SAVAHL

Provider Business Mailing Address
First Line	:	PO BOX 848268
Second Line	:	ATT IPM CREDENTIALING
City	:	DALLAS
State	:	TX
Zip	:	75284-8268
Country	:	US
Telephone Number	:	903-416-1726
Fax Number	:	903-416-1701

Provider Business Practice Location Address
First Line	:	1900 SE 34TH AVE
Second Line	:	UNIT 1800
City	:	AMARILLO
State	:	TX
Zip	:	79118-7771
Country	:	US
Telephone Number	:	806-351-7540
Fax Number	:	806-351-7546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	02/13/2017

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Directions to “ MS. FREDA CECELIA SAVAHL ” Practice Location

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