Individual
AMY MARIE SACKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 TRI PARK WAY, APPLETON, WI 54914-1658
(920) 831-0070
Mailing address
W6014 CORAL CT, APPLETON, WI 54915-7425
(920) 997-9710
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
21096
WI
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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