Individual
SANDRA J PACKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
700 BUFFALO ST, MONDOVI, WI 54755-1371
(715) 838-5222
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
97815
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43860100
—
WI
Enumeration date
03/24/2006
Last updated
04/30/2009
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