Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP013928 | PA |
NPI | 1245646835 |
---|---|
Provider Name | Sarah Packosky |
First Address | Erie, PA 16550-0002 |
Second Address | Erie, PA 16550-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2014 |
Last Update Date | 15/06/2021 |