Individual
STACIA LANGAN SACKMASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
401 ROXBURY RD, ROCKFORD, IL 61107-5075
(815) 397-7340
(815) 397-7388
Mailing address
401 ROXBURY RD, ROCKFORD, IL 61107-5075
(815) 397-7340
(815) 397-7388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209010644
IL
363L00000X
Nurse Practitioner
Primary
AP61603948
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2302946
—
WA
Enumeration date
08/15/2013
Last updated
01/24/2025
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