Individual
MRS. MAMANDOMA SAM-KPAKRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RISGISTERED NURSE
Contact information
Practice address
1253 W BLOOMINGFIELD DR, WHITEWATER, WI 53190-2659
(262) 472-8994
(414) 282-2051
Mailing address
1253 W BLOOMINGFIELD DR, WHITEWATER, WI 53190-2659
(262) 472-8994
(414) 282-2051
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
153910
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35041400
—
WI
Enumeration date
10/09/2008
Last updated
10/09/2008
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