Individual
SALLY R SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
737 GRANT ST, DE PERE, WI 54115-1319
(920) 676-5241
Mailing address
737 GRANT ST, DE PERE, WI 54115-1319
(920) 676-5241
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
168194-30
WI
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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