Provider Demographics
NPI:1083395297
Name:BOOKER, SAVANAH (PA-C)
Entity type:Individual
Prefix:
First Name:SAVANAH
Middle Name:
Last Name:BOOKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 JOE PHILLIPS RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9776
Mailing Address - Country:US
Mailing Address - Phone:256-337-5370
Mailing Address - Fax:
Practice Address - Street 1:115 SAINT CLAIR AVE SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4344
Practice Address - Country:US
Practice Address - Phone:256-519-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2599363A00000X
LA338136363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant