Provider Demographics
NPI:1942476304
Name:SVANOE-WILSON, ANNIKA L
Entity Type:Individual
Prefix:MRS
First Name:ANNIKA
Middle Name:L
Last Name:SVANOE-WILSON
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 1:265 PARKSIDE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3141
Mailing Address - Country:US
Mailing Address - Phone:719-304-2873
Mailing Address - Fax:719-475-2227
Practice Address - Street 1:265 PARKSIDE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3141
Practice Address - Country:US
Practice Address - Phone:719-304-2873
Practice Address - Fax:719-475-2227
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist