Active NPI
Kathleen Lousie Packard, LPN
- Licensed Practical Nurse
- Sun Prairie, WI
National Provider Identifier
1689714396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 7654-031
- Practice address
- 2780 Torbleau Rd
Sun Prairie, WI 53590-9700 - Phone
- (608) 825-3945
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 7654-031 | WI | Primary |
Addresses
Primary practice location
2780 Torbleau Rd
Sun Prairie, WI 53590-9700
Mailing address
2780 Torbleau Rd
Sun Prairie, WI 53590-9700
Phone (608) 825-3945
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42023300 | Medicaid | WI | |
| 7654-031 | Other | WI | STATE LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7654-031 | WI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689714396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2780 TORBLEAU RD",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535909700",
"telephone_number": "608-825-3945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2780 TORBLEAU RD",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535909700",
"telephone_number": "608-825-3945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACKARD",
"first_name": "KATHLEEN",
"middle_name": "LOUSIE",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WI",
"license": "7654-031",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42023300",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "7654-031",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sun Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.