Provider Demographics
NPI:1487891966
Name:KAKANI, SAVITHRI (PAC)
Entity type:Individual
Prefix:MRS
First Name:SAVITHRI
Middle Name:
Last Name:KAKANI
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MRS
Other - First Name:SAVITHRI
Other - Middle Name:
Other - Last Name:KAKANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:1269 SCOTT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1390
Mailing Address - Country:US
Mailing Address - Phone:517-265-3645
Mailing Address - Fax:
Practice Address - Street 1:2727 E BEECHER ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-3506
Practice Address - Country:US
Practice Address - Phone:517-265-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002469363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant