Provider Demographics
NPI:1386355121
Name:WILSON, SAVANNAH LYNN (RD, LD)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LYNN
Last Name:WILSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 NATCHEZ TRL
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-1280
Mailing Address - Country:US
Mailing Address - Phone:256-617-2342
Mailing Address - Fax:
Practice Address - Street 1:4801 UNIVERSITY SQ STE 19
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-1815
Practice Address - Country:US
Practice Address - Phone:256-530-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2025-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5023133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered