Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0024165889 | VA |
NPI | 1013981083 |
---|---|
Provider Name | Cindy H Packer |
First Address | Roanoke, VA 24015-0127 |
Second Address | Fishersville, VA 22939-2635 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 16/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010093317 | (05) | VA |
010093317 | VIRGINIA PREMIER (01) | VA |
085354M | OPTIMA BEHAVORIAL (01) | VA |
172650 | ANTHEM BEHAVORIAL (01) | VA |
5596863 | FIRST HEALTH (01) | VA |
Q24482 | (02) | VA |