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1104015742
SANDRA S NIENABER
ROCKFORD, IL
NPI
1104015742
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209005207)
Enumeration Date
2007-10-19
Last Update Date
2007-10-19
Business Address
Ms. SANDRA S NIENABER
420 E STATE ST WINNEBAGO COUNTY JAIL
ROCKFORD, IL 61104-1015
Phone number: 815-319-6634
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Mailing Address
Ms. SANDRA S NIENABER
1601 PARKVIEW AVE S200
ROCKFORD, IL 61107-1822
Phone number: 815-395-5851
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