Individual
DIANA LEIGH SACKMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
641 W MAIN ST APT 105, MADISON, WI 53703-2695
(608) 251-1275
Mailing address
722 W EDGEWATER ST, PORTAGE, WI 53901-2048
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
128456-30
WI
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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