Provider Demographics
NPI:1285332312
Name:SAGONA, TAMMY M (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:M
Last Name:SAGONA
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5328 HAMILTON LN
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8834
Mailing Address - Country:US
Mailing Address - Phone:850-206-2099
Mailing Address - Fax:
Practice Address - Street 1:102 DORADO DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5672
Practice Address - Country:US
Practice Address - Phone:850-206-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9269078363LF0000X
TX1112451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily