Doctor Name: | BOBBIE J. PACKER |
NPI Number: | 1073815692 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 1-023343 |
Business Practice Address: | 86892 Highway 9 Lineville, AL - 362666949 |
Business Phone Number: | 2563966421 |
Business Fax Number: | 2563969172 |
Mailing Address: | 201 Monroe St Ste 1386, MONTGOMERY |
State: | AL |
Postal Code: | 361043735 |
Phone Number: | 3342067959 |
Fax Number: | 3342063998 |
NPI Enumeration Date: | 12/02/2010 |
NPI Last Update Date: | 12/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-023343 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |