Individual
MRS. BRENDA LEE STACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
401 W MAIN ST, VAN WERT, OH 45891-1640
(419) 238-6772
Mailing address
401 W MAIN ST, VAN WERT, OH 45891-1640
(419) 238-6772
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN090365
OH
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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