Individual
KATHLEEN LOUSIE PACKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2780 TORBLEAU RD, SUN PRAIRIE, WI 53590-9700
(608) 825-3945
Mailing address
2780 TORBLEAU RD, SUN PRAIRIE, WI 53590-9700
(608) 825-3945
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
7654-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42023300
—
WI
01
—
7654-031
STATE LICENSE NUMBER
WI
Enumeration date
02/08/2007
Last updated
07/08/2007
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