Provider Demographics
NPI:1669079083
Name:SAGOE ANNOR, WILHELMINA (DNP)
Entity type:Individual
Prefix:
First Name:WILHELMINA
Middle Name:
Last Name:SAGOE ANNOR
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 E THOMAS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7033
Mailing Address - Country:US
Mailing Address - Phone:480-607-0606
Mailing Address - Fax:480-607-6695
Practice Address - Street 1:6380 E THOMAS RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7033
Practice Address - Country:US
Practice Address - Phone:480-607-0606
Practice Address - Fax:480-607-6695
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ246626363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care