Provider Demographics
NPI:1538808696
Name:SAVAGE, ANITA L
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:L
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 INGALLS RD # 52C
Mailing Address - Street 2:
Mailing Address - City:FORT MONROE
Mailing Address - State:VA
Mailing Address - Zip Code:23651-1019
Mailing Address - Country:US
Mailing Address - Phone:757-284-4000
Mailing Address - Fax:
Practice Address - Street 1:126 INGALLS RD # 52C
Practice Address - Street 2:
Practice Address - City:FORT MONROE
Practice Address - State:VA
Practice Address - Zip Code:23651-1019
Practice Address - Country:US
Practice Address - Phone:757-284-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty