Individual
ROBERTA S PACKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
412 NE FORD ST, MCMINNVILLE, OR 97128-4608
(503) 434-7525
(503) 472-9731
Mailing address
412 NE FORD ST, MCMINNVILLE, OR 97128-4608
(503) 434-7525
(503) 472-9731
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
087006757
OR
163WC1500X
Community Health Registered Nurse
087006757
OR
Other
Enumeration date
10/21/2008
Last updated
10/24/2008
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