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Organization
INDEPENDENT NURSE
Active
Organization
INDEPENDENT NURSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON MARIE BLOMDAHL LPN/RCS (VENTILATOR NURSE)
(414) 525-0515
Entity
Organization
Contact information
Practice address
11226 W JANESVILLE RD, HALES CORNERS, WI 53130-2401
(414) 525-0515
Mailing address
11226 W JANESVILLE RD, HALES CORNERS, WI 53130-2401
(414) 525-0515
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
33596031
WI
Other
Enumeration date
03/14/2006
Last updated
08/22/2020
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