Individual
SAVANNAH STIDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
805 WHIPPLE ST, PRESCOTT, AZ 86301-1617
(928) 771-0701
(928) 717-9398
Mailing address
805 WHIPPLE ST STE D, PRESCOTT, AZ 86301-1617
(928) 771-0701
(928) 717-9398
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120376
—
AZ
Enumeration date
11/19/2014
Last updated
06/05/2022
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