Provider Demographics
NPI:1235790635
Name:SAPP, ANNA MAE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MAE
Last Name:SAPP
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:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-0595
Mailing Address - Country:US
Mailing Address - Phone:307-272-0532
Mailing Address - Fax:
Practice Address - Street 1:840 N DAY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-1614
Practice Address - Country:US
Practice Address - Phone:307-272-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator