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Individual

MRS. LISA MARIE SANDSTROM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
218 ELM CT, RHINELANDER, WI 54501-3409
(715) 499-4949
Mailing address
218 ELM CT, RHINELANDER, WI 54501-3409
(715) 499-4949

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
160147-030
WI
163WH0200X
Home Health Registered Nurse
160147-030
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35070500
WI
Enumeration date
10/14/2008
Last updated
10/14/2008
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