Provider Demographics
NPI:1134505597
Name:OACHS, SANDRA LEIGH (LPN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEIGH
Last Name:OACHS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10772 ZETTERBERG RD
Mailing Address - Street 2:
Mailing Address - City:GRANTSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:54840-8047
Mailing Address - Country:US
Mailing Address - Phone:715-689-2681
Mailing Address - Fax:715-689-2220
Practice Address - Street 1:10772 ZETTERBERG RD
Practice Address - Street 2:
Practice Address - City:GRANTSBURG
Practice Address - State:WI
Practice Address - Zip Code:54840-8047
Practice Address - Country:US
Practice Address - Phone:715-689-2681
Practice Address - Fax:715-689-2220
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-07
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI318663164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse