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Individual

SALLY EILEEN PACKARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
500 W FORT ST, BOISE, ID 83702-4501
(805) 440-9906
Mailing address
4312 E HALE ST, MESA, AZ 85205-4063
(805) 440-9906

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
445071
CA

Other

Enumeration date
01/16/2018
Last updated
10/31/2022
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