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NPI Code Detail

MEDICARE: SANDRA K ROOF NP

MEDICARE:   SANDRA K ROOF  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician733-033WI

General Provider Information

NPI Number : 1043237910
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA K ROOF NP
Provider Business Mailing Address
First Line : 1687 JACKJAY DR
Second Line :
City : SUN PRAIRIE
State : WI
Zip : 53590-8302
Country : US
Telephone Number : 608-279-3951
Fax Number : 855-374-5850
Provider Business Practice Location Address
First Line : 4660 S BILTMORE LN
Second Line :
City : MADISON
State : WI
Zip : 53718-2104
Country : US
Telephone Number : 608-284-8654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 07/29/2024

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Directions to “ SANDRA K ROOF NP” Practice Location

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